Breast sentinel lymph node biopsy using radioisotope injection: is one-day better than two-day protocol?

Sentinel lymph node (SLN) biopsy is an evolving treatment approach for patients with operable breast cancer. There have been a number of variations in the biopsy technique. One is the timing of radioisotope injection, which might have a significant influence on the radiation exposure of the personnel in the operating room. The present study aims to compare the one-day with the two-day protocol to see which one is associated with a lower radiation hazard while giving similar results. There were 60 patients recruited; half of them had the SLN biopsy 4 hours after the injection and the other half 24 hours later. Patient characteristics were comparable in both groups. The mean numbers of SLNs found per patient were 1.46 and 1.96 respectively. There was a statistically significant difference in the dosage of radioactivity present in the resected specimen between both groups of patients. However, there were still a number of confounding factors, so the proposed hypothesis of getting less radiation exposure to the medical personnel by using a two-day approach should be further investigated.