Lymphoscintigraphy and Sentinel Node Localization in Breast Cancer Patients: A Comparison Between 1-Day and 2-Day Protocols

Journal of Nuclear Medicine

Henry W.D. Yeung¹  Hiram S. Cody III¹  Elyn R. Riedel¹  Alla Turlakow¹  Rodolfo Nuñez¹  Samuel D. Yeh¹  Steven M. Larson¹  Mithat Gonen¹  Jane Fey¹ 

[1] Nuclear Medicine Service, Department of Surgery, and Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York Nuclear Medicine Service, Department of Surgery, and Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York Nuclear Medicine Service, Department of Surgery, and Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York

关键词: breast cancer;    lymphatic mapping;    2-d protocol;   

DOI  :  

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

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.

【 授权许可】

Unknown