Sentinel lymph node localization in early breast cancer.
METHODS
Thirty-two patients with clinical node-negative breast cancer underwent sentinel node localization study as part of a National Cancer Institute-sponsored multicenter trial. Anatomical and histopathologic characteristics of sentinel lymph node (SLN) and a kinetic analysis of nodal uptake were studied. Patients were injected with 1 mCi/4 ml unfiltered 99mTc-sulfur colloid in four divided doses around the palpable lesion or immediately adjacent to the excision cavity if prior biopsy was performed. SLN biopsy was performed 1.5-6 hr (mean = 3 hr) postinjection. Intraoperative localization was performed using a gamma probe. All patients underwent complete axillary dissection.


RESULTS
SLN was identified in 30 of 32 (94%) patients. There were no false-negative SLN biopsies.


CONCLUSIONS
This study supports the clinical validity of SLN biopsy in breast cancer and confirms that, unlike the blue dye technique, the learning curve with unfiltered 99mTc-sulfur colloid and the gamma detection probe is short, and SLN localization is achievable in over 90% of cases by surgeons with modest experience. The use of unfiltered 99mTc-sulfur colloid (larger particle size) with larger injected volume permits effective localization of SLNs.
Gulec
S A
SA
Division of Nuclear Medicine, Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Florida 33136, USA.
Moffat
F L
FL
Carroll
R G
RG
Serafini
A N
AN
Sfakianakis
G N
GN
Allen
L
L
Boggs
J
J
Escobedo
D
D
Pruett
C S
CS
Gupta
A
A
Livingstone
A S
AS
Krag
D N
DN
D000328:Adult; D000368:Aged; D001365:Axilla; D001706:Biopsy; D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000556:secondary*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid
D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid