title: [Intraoperative injection of technetium-99m-dextran 500 for the identification of sentinel lymph node in breast cancer].
abstract: OBJECTIVE
  to determine the efficacy of intraoperative injection of Dextran-500-99m-technetium (Tc) for the identification of the sentinel lymph node (SLN) in breast cancer and analyze time to label the SLN in the axillary region.
  
  
  METHODS
  a prospective study between April 2008 and June 2009, which included 74 sentinel lymph node biopsies (SLNB) in patients with breast cancer in stages T1N0 and T2N0. After induction of anesthesia, 0.5 to 1.5 mCi of Dextran-500-99m-Tc filtered 0.22 µm in a volume of 5 mL was injected intraoperative using the subareolar technique for SLNB. After labeling with the radioisotope, 2 mL of patent blue was injected. The time elapsed between injection and the axillary hot spot, the in vivo and ex vivo counts of the hottest nodes, the background count, and the number of SLN identified were documented. Data were analyzed using descriptive statistics with SPSS program, version 18.
  
  
  RESULTS
  we identified the SLN in 100% of cases. The rate of SLN identification with the probe was 98% (73/74 cases). In one case (1.35%) the SLN was labeled only with the blue dye. The mean dose of radioisotope injected was 0.97 ± 0.22 mCi. The average time to label the SLN was 10.7 minutes (± 5.7 min). We identified on average of 1.66 SLN labeled with the radioisotope.
  
  
  CONCLUSIONS
  the procedure for SLN identification with an intraoperative injection of the radioisotope is oncologically safe and comfortable for the patient, providing agility to the surgical team.
authors.affiliation: Programa de Pós-Graduação em Medicina - Ciências Médicas, Universidade Federal do Rio Grande do Sul – UFRGS – Porto Alegre (RS), Brasil. gersonjacob@gmail.com
authors.forename: Gerson Jacob
authors.initials: GJ
authors.lastname: Delazeri
authors.forename: Nilton Leite
authors.initials: NL
authors.lastname: Xavier
authors.forename: Carlos Henrique
authors.initials: CH
authors.lastname: Menke
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Bittelbrunn
authors.forename: Bernardo Leão
authors.initials: BL
authors.lastname: Spiro
authors.forename: Marcos Pretto
authors.initials: MP
authors.lastname: Mosmann
authors.forename: Márcia Silveira
authors.initials: MS
authors.lastname: Graudenz
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D003911:Dextrans / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007267:Injections; D007430:Intraoperative Care; D008875:Middle Aged; D015609:Organotechnetium Compounds / Q000008:administration & dosage*; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000008:administration & dosage*; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*
chemical_list: D003911:Dextrans; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C034146:technetium Tc 99m dextran