Radiation doses to staff involved in sentinel node operations for breast cancer.
BACKGROUND
The use of radioactive compounds for sentinel node biopsy is now a generally accepted part of the surgical treatment of breast cancer and melanoma, with the risk of radiation exposure to the operating team. The aim of this investigation was to study the levels of this exposure in relation to the permissible radiation dose limits.


METHODS
The radiation exposure to the hands and bodies of the operating surgeons (the 'risk persons') was measured by thermoluminescent dosimeters in 79 operations and to the pathologists handling the specimens in 17 cases. Radioactivity and dose rate measurement from tumours and breast specimens were also performed.


RESULTS
During an operation the mean skin dose (+/-SD) to the thermoluminescent dosimeters placed at the hand and the abdominal wall were 0.04 +/- 0.04 mSv (79 operations) and 0.01 +/- 0.02 mSv (67 operations) respectively. For the pathologist, the mean hand dose per operation was below the detection limit (17 operations). Correlation between the measured dose rate and the radioactive content of the tumours was 0.998.


CONCLUSIONS
The radiation exposure to the staff involved in sentinel node (SN) biopsy for breast cancer using radioactive labelled tracers will be considerably below the permissible limits, even with high numbers of SN biopsy procedures. Pregnant staff members should participate in <100 SN operations.
Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, Copenhagen, Denmark. thomas@pet.rh.dk
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Klausen
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Chakera
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Friis
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Rank
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Hesse
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Holm
D001822:Body Burden; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology*; D008207:Lymphatic Metastasis; D009683:Nuclear Medicine; D016273:Occupational Exposure / Q000032:analysis*; D011829:Radiation Dosage; D011834:Radiation Monitoring / Q000379:methods; D011835:Radiation Protection / Q000379:methods; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000032:analysis; D012062:Relative Biological Effectiveness; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013668:Technetium Tc 99m Aggregated Albumin / Q000032:analysis*
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C083602:technetium Tc 99m nanocolloid