Single intralesional tracer dose for radio-guided excision of clinically occult breast cancer and sentinel node

• Published in: Annals of surgical oncology Vol. 8; no. 10; pp. 850 - 855
• Main Authors: Tanis, P J, Deurloo, E E, Valdés Olmos, R A, Rutgers, E J, Nieweg, O E, Besnard, A P, Kroon, B B
• Format: Journal Article
• Language: English
• Published: United States Springer Nature B.V 01.12.2001
• Subjects: Adenocarcinoma - diagnostic imaging; Adenocarcinoma - surgery; Adult; Aged; Aged, 80 and over; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - surgery; Coloring Agents; Feasibility Studies; Female; Humans; Injections, Intralesional; Lymph Nodes - diagnostic imaging; Lymphoscintigraphy; Middle Aged; Neoplasm Staging; Radiopharmaceuticals; Sentinel Lymph Node Biopsy; Technetium Tc 99m Aggregated Albumin
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1007/s10434-001-0850-6

The purpose of this study was to determine the feasibility of both lymphatic mapping and probe-guided primary tumor excision by use of intralesional tracer administration in clinically occult breast cancer. Sixty patients with a clinically occult breast lesion were prospectively included. Lymphoscintigraphy was performed after intratumoral injection of 99mTc-labeled nanocolloid guided by ultrasound or stereotaxis. A catheter over a localization wire was inserted for intraoperative blue dye administration by using the same imaging techniques. After sentinel node identification, the gamma-ray detection probe was used for radio-guided wide local excision in patients who underwent breast-conserving therapy. A sentinel node was visualized on the scintigrams in 56 patients (93%) and could be identified intraoperatively in 58 patients (97%). A sentinel node contained tumor in 10 (17%) of these patients. Extra-axillary sentinel nodes were visualized in 43%, were collected in 38%, and contained metastasis in 7% of the patients. Complete excision of the primary tumor could be accomplished in 39 (87%) of 45 patients. Both sentinel node biopsy and probe-guided excision of a nonpalpable breast cancer is feasible with the aid of intralesional tracer administration. Sentinel node metastasis was found in 17% of the patients. A remarkably high percentage of extra-axillary drainage (43%) was observed.