Safety and Efficacy of Mitoxantrone Hydrochloride Injection for Identification of Axillary Sentinel Lymph Nodes in Patients with Primary Breast Cancer

Area of Science:

• Oncology
• Surgical Oncology
• Medical Imaging

Background:

• The gold standard for sentinel lymph node (SLN) identification in breast cancer patients involves a dual technique using blue dye and a radioisotope.
• Limited access to radioactive materials in some cancer centers poses challenges for SLN identification and patient safety.

Purpose of the Study:

• To evaluate the safety and efficacy of mitoxantrone hydrochloride injection (MHI) for identifying axillary SLNs in primary breast cancer patients.
• To assess MHI as a potential alternative to the radioisotope-based SLN identification method.

Main Methods:

• A prospective, non-randomized analysis was conducted on 296 invasive breast cancer patients between December 2019 and December 2022.
• Data was collected from patient medical records, focusing on SLN intraoperative identification rate as an efficacy marker.
• Safety was assessed through immediate and delayed complication rates and routine blood tests.

Main Results:

• Sentinel lymph nodes were successfully identified in 289 out of 296 patients (97.6%) using MHI.
• Seven patients (2.3%) required four-node sampling due to unsuccessful SLN identification.
• MHI did not significantly affect liver function, and no technique-related readmissions, morbidity, or mortality were reported.

Conclusions:

• Mitoxantrone hydrochloride injection (MHI) demonstrated a high SLN identification rate, suggesting it is a safe and reliable option.
• While MHI is currently inferior to the combined radioactive and blue dye technique for SLN identification, it serves as a viable alternative when radioactive agents are inaccessible.