Lymphoscintigraphy and sentinel node localization in breast cancer patients: A comparison between 1-day and 2-day protocols Journal Article
| Authors: | Yeung, H. W. D.; Cody, H. S. 3rd; Turlakow, A.; Riedel, E. R.; Fey, J.; Gonen, M.; Nuñez, R.; Yeh, S. D.; Larson, S. M. |
| Article Title: | Lymphoscintigraphy and sentinel node localization in breast cancer patients: A comparison between 1-day and 2-day protocols |
| Abstract: | The purpose of this study was to compare the results of isotope injection the morning of surgery (1-d protocol) with isotope injection the day before surgery (2-d protocol) in patients having sentinel lymph node (SLN) biopsy for breast cancer. Methods: The 1-d (protocol 1) and 2-d (protocol 2) protocols included 514 and 152 patients, respectively, treated contemporaneously by surgeons experienced with the SLN biopsy technique. All had preoperative lymphoscintigraphy (LSG) and SLN biopsy using both blue dye and 99mTc-sulfur colloid. All patients had a single-site intradermal injection of unfiltered 99mTc-sulfur colloid in 0.05 mL normal saline: 3.7 MBq (0.1 mCi) on the morning of surgery for protocol 1 and 18.5 MBq (0.5 mCi) on the afternoon before surgery for protocol 2. Results: The patients in protocols 1 and 2 were comparable in terms of age, tumor size, tumor location, histologic type, node positivity, and frequency of a previous surgical biopsy. Comparing protocols 1 and 2, early (30 min) LSG images found the SLN equally often (69% vs. 68%). Isotope identified the SLN equally often at surgery (93% vs. 97%) as did isotope plus dye (98% vs. 99%). A comparable number of SLNs was found (2.5 vs. 2.8 per axilla), and the concordance between isotope and dye in the SLN was also comparable (97% vs. 95%). Late LSG images (at 2 h, possible only for protocol 2) identified the SLN in significantly more patients compared with early images (86% vs. 68%). Conclusion: With unfiltered 99mTc-sulfur colloid injected intradermally, the results of SLN biopsy under the 1-d and 2-d protocols are virtually identical. A 2-d protocol allows increased efficiency in scheduling, both for nuclear medicine physicians and for the operating room, with no compromise in the effectiveness of SLN mapping. |
| Keywords: | adult; aged; aged, 80 and over; middle aged; major clinical study; comparative study; lymph nodes; isosulfan blue; lymphoscintigraphy; preoperative evaluation; radiopharmaceuticals; rosaniline dyes; sentinel lymph node biopsy; technetium tc 99m sulfur colloid; breast cancer; clinical protocol; pathology; breast neoplasms; time; time factors; diagnostic agent; breast tumor; lymph node; radiopharmaceutical agent; scintiscanning; sodium chloride; lymphatic mapping; technetium sulfur colloid tc 99m; humans; human; female; priority journal; article; fuchsine; iso sulfan blue; iso-sulfan blue; 2-d protocol |
| Journal Title: | Journal of Nuclear Medicine |
| Volume: | 42 |
| Issue: | 3 |
| ISSN: | 0161-5505 |
| Publisher: | Society of Nuclear Medicine |
| Date Published: | 2001-03-01 |
| Start Page: | 420 |
| End Page: | 423 |
| Language: | English |
| PUBMED: | 11337517 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 21 May 2015 -- Source: Scopus |
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