title: The use of isotope injections in sentinel node biopsy for breast cancer: are the 1- and 2-day protocols equally effective?
abstract: Sentinel lymph nodes are mapped using (99m)Technetium, injected on day of surgery (1-day protocol) or day before (2-day protocol). This retrospective cohort study compares efficacy between the two protocols. Histopathology for all unilateral sentinel lymph node biopsies (March 2012-March 2013) in a single centre were reviewed. Number of sentinel lymph nodes, non-sentinel lymph nodes and pathology was compared. 2/270 (0.7 %) in 1-day protocol and 8/192 (4 %) in 2-day protocol had no sentinel lymph nodes removed (p = 0.02). The median (range) number of sentinel lymph nodes removed per patient was 2 (0-7) and 1 (0-11) in the 1- and 2-day protocols respectively (p = 0.08). There was a trend for removing more non-sentinel lymph nodes in 2-day protocol [1-day: 52/270 (19 %); 2-day: 50/192 (26 %), p = 0.07]. Using 2-day, sentinel lymph node identification failure rate is higher, although within acceptable rates. The 1 and 2 day protocols are both effective, therefore choice of protocol should be driven by patient convenience and hospital efficiency. However, this study raises the possibility that 1-day may be preferable when higher sentinel lymph node count is beneficial, for example following neoadjuvant chemotherapy.
authors.affiliation: Manchester Medical School, University of Manchester, Stopford Building, Oxford Rd, Manchester, M13 9PT UK.
authors.forename: Nazera
authors.initials: N
authors.lastname: Dodia
authors.affiliation: Department of Breast Surgery, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester, M23 9LT UK.
authors.forename: Deena
authors.initials: D
authors.lastname: El-Sharief
authors.affiliation: Institute of Cancer Sciences, University of Manchester, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester, M23 9LT UK.
authors.forename: Cliona C
authors.initials: CC
authors.lastname: Kirwan
keywords: Breast cancer; Isotope; Sentinel lymph node biopsy; Surgery