title: Cysteine rhenium colloid: a novel radiocolloid for identifying sentinel lymph nodes in breast cancer surgery.
abstract: BACKGROUND
  Medical isotopes are required for sentinel node lymphoscintigraphy in breast cancer, but are in critical shortage. Our center uses a modification of the standard SC, called CRC, that has been shown to require less medical isotope for the same procedure. Our objective was to determine if there was a significant difference between SC and CRC in successful lymph node identification in breast cancer patients.
  
  
  METHODS
  This was a retrospective cohort study using prospectively-collected data on 1205 consecutive early, clinically node-negative breast cancer patients who underwent a SNB between 2002 and 2008 at 2 tertiary hospitals in Canada.
  
  
  RESULTS
  There was no difference in successful lymph node identification rate (P = .50) or in the mean number of positive nodes identified between the 2 colloids (P = .88). The CRC group had a significantly lower rate of delayed adverse events (4.91% vs. 0.59%, P < .0001) even after adjusting for whether axillary dissection occurred on the same day as the biopsy (adjusted odds ratio, 0.12; 95% confidence interval, 0.04-0.40; P = .001).
  
  
  CONCLUSIONS
  Our findings suggest that there is no significant difference between CRC and SC in detecting sentinel nodes; however, CRC uses less medical isotopes. In the current climate of critical shortages of medical radioisotopes, radiocolloids should be selected for use based on amount of radioisotope required.
authors.affiliation: Department of Surgery, Western University Schulich School of Medicine and Dentistry, London, Ontario, Canada.
authors.forename: Biniam
authors.initials: B
authors.lastname: Kidane
authors.affiliation: Department of Medical Imaging, Western University Schulich School of Medicine and Dentistry, London, Ontario, Canada; Department of Nuclear Medicine, London Health Sciences Centre, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada.
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Zabel
authors.affiliation: Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom.
authors.forename: Vaibhav
authors.initials: V
authors.lastname: Gupta
authors.affiliation: Department of Surgery, Western University Schulich School of Medicine and Dentistry, London, Ontario, Canada; Department of Medical Imaging, Western University Schulich School of Medicine and Dentistry, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada.
authors.forename: Caroline
authors.initials: C
authors.lastname: Whiston
authors.affiliation: Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Frances
authors.initials: F
authors.lastname: Wright
authors.affiliation: Department of Surgery, Western University Schulich School of Medicine and Dentistry, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Department of Surgery, London Health Sciences Centre, London, Ontario, Canada. Electronic address: muriel.brackstone@lhsc.on.ca.
authors.forename: Muriel
authors.initials: M
authors.lastname: Brackstone
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery*; D003102:Colloids; D003545:Cysteine; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008207:Lymphatic Metastasis; D008408:Mastectomy; D008875:Middle Aged; D011868:Radioisotopes; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012211:Rhenium; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*
chemical_list: D003102:Colloids; D011868:Radioisotopes; D019275:Radiopharmaceuticals; D012211:Rhenium; D003545:Cysteine
keywords: Clinical trial; Lymphoscintigraphy; Nuclear medicine; Sentinel node biopsy; Sulfur colloid