Early-stage diagnosis of breast cancer remains a critical objective in contemporary medicine, facilitated by advancements in screening techniques such as bilateral mammography and breast ultrasound. These methods enable the detection of small lesions (<10 mm) or early-stage abnormalities, such as microcalcifications typically indicative of in situ carcinomas. Consequently, precise localization of non-palpable lesions to ensure complete surgical excision poses a significant challenge for breast surgeons. Despite the availability of a wide array of localization techniques, Radio-Guided Occult Lesion Localization (ROLL) retains a pivotal role in breast-conserving surgery. This approach involves the intralesional administration of a radioactive tracer—comprising macroaggregates of human serum albumin labelled with technetium-99 m—under ultrasound or stereotactic mammographic guidance. Using a gamma-detection probe, the lesion can be accurately localized, facilitating intraoperative assessment and guiding surgical resection. The successful implementation of ROLL necessitates a multidisciplinary approach, underscoring the importance of collaboration with nuclear medicine specialists. This interdisciplinary framework ensures optimal application of the technique and enhances outcomes in breast cancer surgery.