This procedure is required to surgically remove the abnormal area in the breast detected by mammography or ultrasound that cannot be felt. To help the surgeon to remove breast abnormality, the area of breast tissue needs to be pinpointed by a special procedure called a Radio-guided Localization procedure, in which a small amount of radioactive substance is injected into the abnormal breast tissue and then probed to find the area of concern.

Radio-guided Localization is usually needed when an abnormal area in the breast has been seen on the mammogram or ultrasound but cannot be felt. The surgeon needs to be guided to this area, as there is no lump to feel.

The patient will be required to attend the pre-operative assessment prior to the surgery to assess general health. The patient will need a blood test, a chest X-ray and an ECG. Dr. Naresh might also tell you to follow fasting for a certain period of time before the procedure. ROLL doesn’t require anesthesia but it will be required before surgery.

Mammography or ultrasound is used to identify the abnormal area. A radiologist will clean and numb the skin. A fine needle is introduced into the breast to locate the area to be removed and the correct position will be confirmed by another mammogram or ultrasound scan. A tiny amount of radioactive isotope is then injected into the breast where the abnormal area has been located and the needle is removed. A small dressing is placed on the injection site. The patient returns to the ward prior to theatre. The whole process takes a few minutes. After the area of concern is found, it will be removed from the breast. This procedure can be combined with a Sentinel Lymph Node Biopsy, if needed.

There are no special precautions needed for this procedure. The radiation dose represents a very low risk. The patients need not to avoid contact with children or pregnant women after undergoing this procedure. If the isotope localization fails, an alternative technique might have to be used for example, wire localization.