Evolution of sentinel lymph node biopsy for breast cancer patients in a rural setting: 10 years' experience

Sentinel lymph node (SLN) biopsy is the standard axillary staging procedure of early breast cancer. Superparamagnetic iron oxide (SPIO) nanoparticles have been found to be comparable to, while overcoming many of the limitations associated with, the current standard of care for SLN biopsies (dual localisation with radioisotope and patent blue dye). Here, SPIO dual localisation (Sienna+® and blue dye) is compared to blue dye alone for SLN biopsies in a rural centre where radioisotope techniques are not readily available. Sienna+® dual localisation is shown to be more likely to detect nodes (detection rate of 99% compared to 90% when using blue dye alone), and detect more nodes, than blue dye alone. The use of Magseed, a magnetic tracer, was not found to influence node detection. The results from this work show that Sienna+® dual localisation is superior to blue dye alone for detecting SLN, suggesting that it is an excellent alternative to dual localisation of radioisotope and blue dye for small centres lacking easy access to a nuclear medicine department.