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Related Experiment Videos

Radiation safety with breast sentinel node biopsy.

S L Stratmann1, T M McCarty, J A Kuhn

  • 1Department of Surgery, Baylor University Medical Center, Dallas, Texas 75246, USA.

American Journal of Surgery
|February 12, 2000
PubMed
Summary

Radiation exposure from Technetium 99m sulfur colloid (Tc99m) during breast sentinel lymph node biopsy is minimal for operating room staff and equipment. Special handling is not required for most items, but lumpectomy specimens need decontamination.

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Area of Science:

  • Nuclear Medicine
  • Surgical Oncology
  • Radiological Safety

Background:

  • Sentinel lymph node biopsy (SLNB) using Technetium 99m sulfur colloid (Tc99m) is an advanced technique for breast cancer staging.
  • Concerns exist regarding radiation exposure to healthcare professionals and equipment when using radioactive agents in surgery.
  • This study aimed to quantify radiation exposure during Tc99m-guided SLNB for breast cancer.

Purpose of the Study:

  • To evaluate radiation exposure levels for operating room personnel, pathologists, and surgical equipment during breast SLNB.
  • To determine the safety and handling requirements for specimens and equipment contaminated with Tc99m.

Main Methods:

  • Twenty patients undergoing SLNB received Tc99m sulfur colloid injections.
  • Geiger counter measurements assessed dose rates from injection sites, lumpectomy specimens, and sentinel nodes at various distances.

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  • Radiation levels of instruments, waste, and pathology equipment were measured post-procedure.

    • Main Results:

    • Highest exposure rates were to the surgeon's hands from the injection site (34.25 mRem/h).
    • Pathologist exposure was higher from lumpectomy specimens (18.62 mRem/h hands) than sentinel nodes.
    • All lumpectomy specimens exceeded exempt radiation levels; most sentinel nodes, trash, and suction canisters were at background levels.

    Conclusions:

    • Radiation exposure during Tc99m-guided SLNB is minimal, with personnel able to perform thousands of procedures before exceeding safety limits.
    • Standard surgical instruments, slides, and cryostats do not require special handling.
    • Lumpectomy specimens require decontamination; intraoperative monitoring aids selective decontamination of other materials, reducing disposal time and costs.