title: Pre-operative assessment of axillary lymph node status in patients with breast adenocarcinoma using intravenous 99mtechnetium mAb-170H.82 (Tru-Scint AD).
abstract: Immunoscintigraphy of the axilla has potential utility for the diagnostic and prognostic assessment of patients with breast adenocarcinoma. mAb-170H.82 is a murine monoclonal antibody (mAb) derived against synthetic Thomsen-Friedenreich (TF) antigen. Tru-Scint AD, a 99mTc-mAb-170H.82 immunoconjugate, has previously been shown to localize in various human adenocarcinomas. The purpose of this study was to evaluate the accuracy of this immunoconjugate in the pre-operative assessment of axillary lymph nodes in patients with known breast adenocarcinoma. Sixteen patients with documented primary breast cancer were injected intravenously with 1 mg of immunoconjugate (radioactivity 1.8 GBq) and imaged 22-24 hrs post-injection. Both planar and single photon emission computed tomographic (SPECT) images were obtained and reviewed in a blinded fashion. Imaging results were compared with surgical and pathological findings. Seven of 16 patients were found to have histologically positive axillary nodes: 5 of these sites were detected by immunoscintigraphy (sensitivity = 71%). Nine patients had pathologically disease-free axillary nodes: only 1 of these was misidentified as positive by immunoscintigraphy (specificity = 89%). These results suggest that immunoscintigraphy with 99mTc-mAb-170H.82 has promise in the detection of axillary lymph node involvement in patients with breast cancer. Further studies are warranted to define the role of immunoscintigraphy in axillary staging.
authors.affiliation: Department of Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Dessureault
authors.forename: I
authors.initials: I
authors.lastname: Koven
authors.forename: R M
authors.initials: RM
authors.lastname: Reilly
authors.forename: J
authors.initials: J
authors.lastname: Couture
authors.forename: B
authors.initials: B
authors.lastname: Schmocker
authors.forename: M
authors.initials: M
authors.lastname: Damani
authors.forename: J
authors.initials: J
authors.lastname: Kirsh
authors.forename: M
authors.initials: M
authors.lastname: Ichise
authors.forename: S
authors.initials: S
authors.lastname: Sidlofsky
authors.forename: A J
authors.initials: AJ
authors.lastname: McEwan
authors.forename: G
authors.initials: G
authors.lastname: Boniface
authors.forename: H
authors.initials: H
authors.lastname: Stern
authors.forename: S
authors.initials: S
authors.lastname: Gallinger
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000191:economics / Q000601:surgery; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D058846:Antibodies, Monoclonal, Murine-Derived; D001365:Axilla / Q000000981:diagnostic imaging* / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000191:economics / Q000601:surgery; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008875:Middle Aged; D009367:Neoplasm Staging; D015609:Organotechnetium Compounds / Q000008:administration & dosage*; D011446:Prospective Studies; D015899:Tomography, Emission-Computed, Single-Photon / Q000191:economics
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D015609:Organotechnetium Compounds; C109623:technetium Tc 99m-monoclonal antibody-170H.82