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Related Experiment Videos

Sentinel lymph node biopsy using tin colloid RI and blue dye method.

T Ikeda1, S Masamura, H Fujii

  • 1Department of Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo 160-8582, Japan.

Breast Cancer (Tokyo, Japan)
|December 15, 2000
PubMed
Summary
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Sentinel lymph node biopsy using tin colloid and RI imaging improves detection rates for breast cancer staging. This method offers high accuracy and sensitivity, potentially reducing unnecessary axillary dissections and associated morbidity.

Area of Science:

  • Oncology
  • Nuclear Medicine
  • Surgical Pathology

Background:

  • Axillary dissection is crucial for breast cancer staging due to nodal metastasis predicting recurrence.
  • However, axillary dissection can lead to significant morbidity, including lymphedema and shoulder dysfunction.
  • Sentinel node biopsy offers a less invasive alternative to avoid unnecessary axillary dissections.

Purpose of the Study:

  • To evaluate the efficacy of sentinel lymph node biopsy in breast cancer staging.
  • To compare the detection rates, sensitivity, specificity, and accuracy of the blue dye method, the radioisotope (RI) method using Tc99m tin colloid, and a combined approach.
  • To assess the impact of tumor-adjacent subcutaneous injection on RI method detection rates.

Main Methods:

  • The study employed both the blue dye method and a radioisotope (RI) method using Tc99m tin colloid as a tracer.

Related Experiment Videos

  • The RI method involved injecting Tc99m tin colloid, with a modification of adding subcutaneous injection over the tumor.
  • Detection rates, false negative rates, sensitivity, specificity, accuracy, and the number of identified sentinel lymph nodes were analyzed for each method.

    • Main Results:

    • The combined method achieved an 82% sentinel node detection rate, while the blue dye method achieved 90% and the RI method achieved 53% (improved to 82% with tumor-adjacent injection).
    • The RI method demonstrated a 0% false negative rate, compared to 11% for the blue dye method and 10% for the combined method.
    • All methods showed 100% specificity, with the RI method achieving 100% accuracy, compared to 96% for the blue dye and combined methods.

    Conclusions:

    • Lymphatic mapping using Tc99m tin colloid, particularly with tumor-adjacent subcutaneous injection, is a valuable technique for sentinel lymph node detection in breast cancer.
    • The RI method offers high sensitivity and accuracy, potentially improving staging and reducing morbidity associated with complete axillary dissection.
    • Further investigation into parasternal lymph node identification via RI imaging may also be beneficial.