Abstract
Background
Preoperative injection of Tc99 is standardly performed before sentinel lymph node
biopsy (SLN) for breast cancer. Multiple questions have arisen concerning appropriate
technique for SLNBs including site of injection, timing and injection material. The
aim of this study was to assess the concordance between a new method, superparamagnetic
iron oxide (SPIO) and the Tc99 radiotracer to identify the SLN in early breast cancer.
Material and methods
Between July 2013 and March 2014, 120 patients with clinically node negative early
breast cancer were included in the study. Patients were injected the day before the
radiotracer for lymphoscintigraphy and injected the SPIO subareolar intraoperatively.
SLN was excised if it was radioactive, magnetic or palpable. Patients signed an inform
consent.
Results
There was no drainage by either technique in 2 patients, so this leaves 118 patients
for further analysis. Detection rate by Tc 99 was successful in 113 (95.7%%) patients
and by SPIO in 116 (98.3%). Concordance rates per patient between techniques was 98.2%.
The SLN was positive in 36 (30%) patients. Of this, SLN positivity was detected by
both techniques in 32 patients. Mean number of SLNs by 99Tc and SPIO were 1.9 and
2.21 respectively (p = 0.001).
Discussion
Detection of SLNs with SPIO allows for easy identification of axillary nodes, at a
frequency not inferior to the radiotracer. It is an oncologically safe procedure,
facilitates patients and operative room management and can be used to reliably identify
SLNs in breast cancer.
Keywords
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Article info
Publication history
Published online: November 15, 2014
Accepted:
November 6,
2014
Footnotes
☆Presented at the EBCC-9 European Breast Cancer Conference, 19–21 March 2014 Glasgow, United Kingdom.
Identification
Copyright
© 2014 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
