Radioactivity thresholds for sentinel node biopsy in breast cancer

Morota, S.; Koizumi, M.; Koyama, M.; Sugihara, T.; Tada, K.-I.; Miyagi, Y.; Nishimura, S.-I.; Makita, M.; Iwase, T.; Yoshimoto, M.; Kasumi, F.

doi:10.1016/j.ejso.2006.03.017

« Previous Next »European Journal of Surgical Oncology
Volume 32, Issue 10 , Pages 1101-1104, December 2006

Radioactivity thresholds for sentinel node biopsy in breast cancer

S. Morota
- Department of Nuclear Medicine, Cancer Institute Hospital, Ariake 3-10-6, Koto-ku, Tokyo 135-8550, Japan
- Department of Breast Surgery, Cancer Institute Hospital, Ariake 3-10-6, Koto-ku, Tokyo 135-8550, Japan
M. Koizumi
- Department of Nuclear Medicine, Cancer Institute Hospital, Ariake 3-10-6, Koto-ku, Tokyo 135-8550, Japan
- Corresponding author. Tel.: +81 3 3570 0205; fax: +81 3 3570 0204.
M. Koyama
- Department of Nuclear Medicine, Cancer Institute Hospital, Ariake 3-10-6, Koto-ku, Tokyo 135-8550, Japan
T. Sugihara
- Department of Nuclear Medicine, Cancer Institute Hospital, Ariake 3-10-6, Koto-ku, Tokyo 135-8550, Japan
- Department of Breast Surgery, Cancer Institute Hospital, Ariake 3-10-6, Koto-ku, Tokyo 135-8550, Japan
K.-I. Tada
- Department of Breast Surgery, Cancer Institute Hospital, Ariake 3-10-6, Koto-ku, Tokyo 135-8550, Japan
Y. Miyagi
- Department of Breast Surgery, Cancer Institute Hospital, Ariake 3-10-6, Koto-ku, Tokyo 135-8550, Japan
S.-I. Nishimura
- Department of Breast Surgery, Cancer Institute Hospital, Ariake 3-10-6, Koto-ku, Tokyo 135-8550, Japan
M. Makita
- Department of Breast Surgery, Cancer Institute Hospital, Ariake 3-10-6, Koto-ku, Tokyo 135-8550, Japan
T. Iwase
- Department of Breast Surgery, Cancer Institute Hospital, Ariake 3-10-6, Koto-ku, Tokyo 135-8550, Japan
M. Yoshimoto
- Department of Breast Surgery, Cancer Institute Hospital, Ariake 3-10-6, Koto-ku, Tokyo 135-8550, Japan
F. Kasumi
- Department of Breast Surgery, Cancer Institute Hospital, Ariake 3-10-6, Koto-ku, Tokyo 135-8550, Japan

Accepted 6 March 2006.

Abstract

Aims

The aim of the present study is to clarify the level of radioactive lymph node should be biopsied after the most radioactive SN is removed.

Methods

SNB using radionuclide was performed in our hospital for 1179 primary breast cancers between April 2000 and October 2005; most (1177/1179) were performed successfully. Our criterion for harvesting SNs is to remove tissue until no radioactive site is present. The level of radioactivity and the order of removal of each lymph node were compared with pathologic results.

Results

More than 2 (overall average 1.9) radioactive SNs were biopsied in 686 of 1177 breasts. Cancer positive results were recorded for 142 breasts with multiple SNs. In 142 breasts, 64 showed metastasis to the most radioactive node only, 39 showed metastasis other than the most radioactive node only, and 39 showed the most radioactive node and other radioactive nodes. Moreover, if several other criteria were applied, false-positive cases were increased significantly.

Conclusions

It is necessary to harvest radioactive lymph nodes other than the most radioactive. Moreover, efforts to remove every radioactive lymph node will minimize false-negative results.

Keywords: Sentinel node biopsy, Breast cancer, Lymph node metastasis