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Related Experiment Videos

Gamma probe-guided sentinel node biopsy--optimal timing for injection

S Schneebaum1, J Stadler, M Cohen

  • 1Department of Surgery A, Ichilov Hospital, Tel-Aviv Sourasky Medical Center, Israel.

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
|December 31, 1998
PubMed
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Sentinel lymph node (SLN) localization in breast cancer is feasible using a gamma-detecting probe (GDP) and radiolabeled colloid. Injection 2-24 hours pre-surgery is suitable, but prior radiotherapy may hinder localization.

Area of Science:

  • Oncology
  • Nuclear Medicine
  • Surgical Oncology

Background:

  • Sentinel lymph node (SLN) biopsy is crucial for accurate breast cancer staging.
  • Accurate SLN localization is essential to avoid unnecessary axillary lymph node dissection.
  • Radiolabeled colloid and gamma-detecting probes offer a potential method for SLN identification.

Purpose of the Study:

  • To assess the feasibility of using a gamma-detecting probe (GDP) and radiolabeled colloid for SLN localization in breast cancer.
  • To determine optimal injection timing for radiolabeled colloid for SLN detection.
  • To identify potential exclusion criteria for this SLN localization technique.

Main Methods:

  • A Phase I feasibility study involved 30 breast cancer patients diagnosed via fine needle aspiration (FNA).

Related Experiment Videos

  • Patients received an injection of 99mTc-labeled rhenium colloid (Tck-17).
  • Scintigraphy was performed at various time points (20 min, 2, 6, 25 hours); SLN localization during surgery was attempted using a GDP and patent blue dye.

    • Main Results:

    • The SLN was successfully identified by the GDP in 28 out of 30 patients during surgery.
    • Scintigraphy at 2 hours post-injection accurately predicted SLN location, consistent with 24-hour images.
    • Prior radiotherapy was associated with failed SLN localization in two patients; metastases were found in seven SLNs.

    Conclusions:

    • Injection of radiolabeled colloid 2 to 24 hours before surgery is a suitable timing for SLN localization.
    • Previous radiotherapy is a predictor of procedural failure.
    • Further research is required to establish the precise false-negative rate of this method in breast cancer patients.