Surgeon Injected Technetium-99m for Sentinel Lymph Node Biopsies in Breast Cancer-Outcomes in a Regional Hospital

Area of Science:

• Oncology
• Nuclear Medicine
• Surgical Oncology

Background:

• Sentinel lymph node biopsy is crucial for breast cancer staging.
• Technetium-99m (Tc-99m) injection is the standard for sentinel node localisation.
• Current Tc-99m administration logistics pose challenges for regional hospitals.

Purpose of the Study:

• To compare outcomes of surgeon-administered Tc-99m injection versus traditional nuclear medicine administration.
• To assess the impact of surgeon-administered Tc-99m on blue dye requirement and node yield.

Main Methods:

• Retrospective review of breast cancer patients undergoing sentinel lymph node biopsy (July 2021-July 2023).
• Comparison between patients receiving Tc-99m injection from nuclear medicine versus surgical teams.
• Exclusion criteria included neoadjuvant therapy, axillary dissection, or insufficient data.

Main Results:

• Surgeon injection group (97 patients) had 100% Tc-99m administration, unlike the nuclear medicine group (85 patients) where 21% missed the injection.
• Significantly lower blue dye requirement in the surgeon-injected group (17.5% vs. 36.0%, p=0.004).
• No significant difference in the mean number of nodes harvested (3.24 vs. 3.77, p=0.076).

Conclusions:

• Preoperative surgeon-administered Tc-99m injection enhances accessibility for sentinel node biopsy.
• This approach significantly reduces reliance on blue dye.
• Sentinel node localisation and lymph node yield are maintained with surgeon-administered Tc-99m.