Abstract
Background: There are few clinical data on technical limitations and radiocolloid kinetics related to sentinel lymph node (SLN) biopsy for breast cancer. Methods: In 70 clinical node-negative patients, unfiltered 99mTc sulfur-colloid was injected peritumorally and cutaneous hot spots were mapped with a gamma probe. SLN biopsy was performed followed by axillary lymph node dissection. Missed radioactive nodes (nodes not under hot spots) were removed from axillary lymph node dissection specimens and submitted separately. Results: At least one hot spot was mapped in 69 patients (98%) and SLNs were retrieved in 62 (89%). No radiolabeled nodes were found in five (7%) and only nodes not under hot spots were retrieved in three patients (4%). Residual nodes not under hot spots were retrieved in 17 patients (24%) in whom at least one SLN specimen had been found. Diffuse radioactivity around the radiocolloid injection site impeded identification of all radiolabeled nodes during SLN biopsy, and was responsible for one of two false negatives (20 node-positive patients; false-negative rate 10%). Hot spot radioactivity, number of radiolabeled nodes, and nodal radioactivity did not change with time interval from radiocolloid injection to surgery (0.75-6.25 hours). Conclusions: Although SLN localization rate is high, intraparenchymal injection may predispose to failure of radiocolloid migration, failure to identify SLNs because of high radiation background, and false-negative outcomes. Alternative routes of radiocolloid administration should be explored.
| Original language | English |
|---|---|
| Pages (from-to) | 746-755 |
| Number of pages | 10 |
| Journal | Annals of Surgical Oncology |
| Volume | 6 |
| Issue number | 8 |
| State | Published - Dec 1 1999 |
Fingerprint
Keywords
- Gamma detection probe
- Radiocolloid
- Sentinel node biopsy
ASJC Scopus subject areas
- Surgery
- Oncology
Cite this
Unfiltered sulfur colloid and sentinel node biopsy for breast cancer : Technical and kinetic considerations. / Moffat, Frederick L; Gulec, Seza A.; Sittler, Scott Y.; Serafini, Aldo N; Sfakianakis, George N; Boggs, Jodeen E.; Franceschi, Dido; Pruett, Christopher S.; Pop, Raoul; Gurkok, Cem; Livingstone, Alan; Krag, David N.
In: Annals of Surgical Oncology, Vol. 6, No. 8, 01.12.1999, p. 746-755.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Unfiltered sulfur colloid and sentinel node biopsy for breast cancer
T2 - Technical and kinetic considerations
AU - Moffat, Frederick L
AU - Gulec, Seza A.
AU - Sittler, Scott Y.
AU - Serafini, Aldo N
AU - Sfakianakis, George N
AU - Boggs, Jodeen E.
AU - Franceschi, Dido
AU - Pruett, Christopher S.
AU - Pop, Raoul
AU - Gurkok, Cem
AU - Livingstone, Alan
AU - Krag, David N.
PY - 1999/12/1
Y1 - 1999/12/1
N2 - Background: There are few clinical data on technical limitations and radiocolloid kinetics related to sentinel lymph node (SLN) biopsy for breast cancer. Methods: In 70 clinical node-negative patients, unfiltered 99mTc sulfur-colloid was injected peritumorally and cutaneous hot spots were mapped with a gamma probe. SLN biopsy was performed followed by axillary lymph node dissection. Missed radioactive nodes (nodes not under hot spots) were removed from axillary lymph node dissection specimens and submitted separately. Results: At least one hot spot was mapped in 69 patients (98%) and SLNs were retrieved in 62 (89%). No radiolabeled nodes were found in five (7%) and only nodes not under hot spots were retrieved in three patients (4%). Residual nodes not under hot spots were retrieved in 17 patients (24%) in whom at least one SLN specimen had been found. Diffuse radioactivity around the radiocolloid injection site impeded identification of all radiolabeled nodes during SLN biopsy, and was responsible for one of two false negatives (20 node-positive patients; false-negative rate 10%). Hot spot radioactivity, number of radiolabeled nodes, and nodal radioactivity did not change with time interval from radiocolloid injection to surgery (0.75-6.25 hours). Conclusions: Although SLN localization rate is high, intraparenchymal injection may predispose to failure of radiocolloid migration, failure to identify SLNs because of high radiation background, and false-negative outcomes. Alternative routes of radiocolloid administration should be explored.
AB - Background: There are few clinical data on technical limitations and radiocolloid kinetics related to sentinel lymph node (SLN) biopsy for breast cancer. Methods: In 70 clinical node-negative patients, unfiltered 99mTc sulfur-colloid was injected peritumorally and cutaneous hot spots were mapped with a gamma probe. SLN biopsy was performed followed by axillary lymph node dissection. Missed radioactive nodes (nodes not under hot spots) were removed from axillary lymph node dissection specimens and submitted separately. Results: At least one hot spot was mapped in 69 patients (98%) and SLNs were retrieved in 62 (89%). No radiolabeled nodes were found in five (7%) and only nodes not under hot spots were retrieved in three patients (4%). Residual nodes not under hot spots were retrieved in 17 patients (24%) in whom at least one SLN specimen had been found. Diffuse radioactivity around the radiocolloid injection site impeded identification of all radiolabeled nodes during SLN biopsy, and was responsible for one of two false negatives (20 node-positive patients; false-negative rate 10%). Hot spot radioactivity, number of radiolabeled nodes, and nodal radioactivity did not change with time interval from radiocolloid injection to surgery (0.75-6.25 hours). Conclusions: Although SLN localization rate is high, intraparenchymal injection may predispose to failure of radiocolloid migration, failure to identify SLNs because of high radiation background, and false-negative outcomes. Alternative routes of radiocolloid administration should be explored.
KW - Gamma detection probe
KW - Radiocolloid
KW - Sentinel node biopsy
UR - http://www.scopus.com/inward/record.url?scp=17344382186&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=17344382186&partnerID=8YFLogxK
M3 - Article
C2 - 10622502
AN - SCOPUS:17344382186
VL - 6
SP - 746
EP - 755
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
SN - 1068-9265
IS - 8
ER -