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.
Division of Nuclear Medicine, Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Florida 33136, USA.
S A
SA
Gulec
F L
FL
Moffat
R G
RG
Carroll
A N
AN
Serafini
G N
GN
Sfakianakis
L
L
Allen
J
J
Boggs
D
D
Escobedo
C S
CS
Pruett
A
A
Gupta
A S
AS
Livingstone
D N
DN
Krag
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