Masakuni Noguchi1, Masashi Inokuchi, Yo Zen. 1. Department of Breast Oncology, Kanazawa University Hospital, Kanazawa, Japan. nogumasa@kanazawa-med.ac.jp
Abstract
BACKGROUND: The optimal site for injection of mapping tracers is controversial in sentinel lymph node (SLN) biopsy for breast cancer. We evaluated whether a combination of peritumoral (PT) injection and subareolar (SA) injection can improve the identification rate of SLN biopsy and decrease the false-negative rate. METHODS: Two hundred one patients underwent SLN biopsy with PT injection of radioisotope and SA injection of blue dye. RESULTS: The overall identification rate for blue and/or hot lymph nodes was 99.5%; the identification rate of blue-dyed lymph nodes was 98.0% and that of hot lymph nodes was 97.0%. However, no concordance between the hot node and the blue node was found in 17 patients (8.5%). Among SLN-positive 51 patients, 4 patients had blue-only positive SLN and 7 had hot-only positive SLN. Consequently, the false-negative rates were at least 7.8% for PT injection and 13.7% for SA injection, while axillary lymph node dissection was not performed in SLN-negative patients. However, a combination of both injections significantly decreased the false-negative rate. CONCLUSIONS: The success of SLN mapping is optimized not only by using dye and isotope in combination but also by using PT and SA injections in combination.
BACKGROUND: The optimal site for injection of mapping tracers is controversial in sentinel lymph node (SLN) biopsy for breast cancer. We evaluated whether a combination of peritumoral (PT) injection and subareolar (SA) injection can improve the identification rate of SLN biopsy and decrease the false-negative rate. METHODS: Two hundred one patients underwent SLN biopsy with PT injection of radioisotope and SA injection of blue dye. RESULTS: The overall identification rate for blue and/or hot lymph nodes was 99.5%; the identification rate of blue-dyed lymph nodes was 98.0% and that of hot lymph nodes was 97.0%. However, no concordance between the hot node and the blue node was found in 17 patients (8.5%). Among SLN-positive 51 patients, 4 patients had blue-only positive SLN and 7 had hot-only positive SLN. Consequently, the false-negative rates were at least 7.8% for PT injection and 13.7% for SA injection, while axillary lymph node dissection was not performed in SLN-negative patients. However, a combination of both injections significantly decreased the false-negative rate. CONCLUSIONS: The success of SLN mapping is optimized not only by using dye and isotope in combination but also by using PT and SA injections in combination.
Authors: Francesco Giammarile; Naomi Alazraki; John N Aarsvold; Riccardo A Audisio; Edwin Glass; Sandra F Grant; Jolanta Kunikowska; Marjut Leidenius; Valeria M Moncayo; Roger F Uren; Wim J G Oyen; Renato A Valdés Olmos; Sergi Vidal Sicart Journal: Eur J Nucl Med Mol Imaging Date: 2013-10-02 Impact factor: 9.236
Authors: Paolo Orsaria; Dimitrios Varvaras; Gianluca Vanni; Giampiero Pagnani; Jacopo Scaggiante; Federico Frusone; Alessandra Vittoria Granai; Giuseppe Petrella; Oreste Claudio Buonomo Journal: Int J Breast Cancer Date: 2014-02-11