The Nordic SentiMag trial: a comparison of super paramagnetic iron oxide (SPIO) nanoparticles versus Tc99 and patent blue in the detection of sentinel node (SN) in patients with breast cancer and a meta-analysis of earlier studies

The aim of the study is to compare the efficacy of SPIO as a tracer in sentinel node biopsy (SNB) in breast cancer with Tc and patent blue in a multicentre prospective study and perform a meta-analysis of all published studies. It also aims to follow skin discoloration after SPIO injection and descr...

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Published inBreast cancer research and treatment Vol. 157; no. 2; pp. 281 - 294
Main Authors Karakatsanis, Andreas, Christiansen, Peer Michael, Fischer, Lone, Hedin, Christina, Pistioli, Lida, Sund, Malin, Rasmussen, Nils Ryegaard, Jørnsgård, Hjørdis, Tegnelius, Daniel, Eriksson, Staffan, Daskalakis, Kosmas, Wärnberg, Fredrik, Markopoulos, Christos J., Bergkvist, Leif
Format Journal Article
LanguageEnglish
Published New York Springer US 2016
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Abstract The aim of the study is to compare the efficacy of SPIO as a tracer in sentinel node biopsy (SNB) in breast cancer with Tc and patent blue in a multicentre prospective study and perform a meta-analysis of all published studies. It also aims to follow skin discoloration after SPIO injection and describe when and how it resolves. Totally 206 patients with early breast cancer were recruited. Tc and patent blue were administered in standard fashion. Patients were injected with SPIO (Sienna+) preoperatively. SNB was performed and detection rates were recorded for both methods. Skin discoloration was followed and documented postoperatively. Data extraction and subsequent meta-analysis of all previous studies were also performed. SN detection rates were similar between standard technique succeeded and SPIO both per patient (97.1 vs. 97.6 %, p  = 0.76) as well as per node (91.3 vs. 93.3 %, p  = 0.34), something which was not affected by the presence of malignancy. Concordance rates were also consistently high (98.0 % per patient and 95.9 % per node). Discoloring was present in 35.5 % of patients postoperatively, almost exclusively in breast conservation. It fades slowly and is still detectable in 8.6 % of patients after 15 months. Meta-analysis depicted similar detection rates ( p  = 0.71) and concordance rates ( p  = 0.82) per patient. However, it seems that SPIO is characterized by higher nodal retrieval ( p  < 0.001). SPIO is an effective method for the detection of SN in patients with breast cancer. It is comparable to the standard technique and seems to simplify logistics. Potential skin discoloration is something of consideration in patients planned for breast conservation.
AbstractList The aim of the study is to compare the efficacy of SPIO as a tracer in sentinel node biopsy (SNB) in breast cancer with Tc and patent blue in a multicentre prospective study and perform a meta-analysis of all published studies. It also aims to follow skin discoloration after SPIO injection and describe when and how it resolves. Totally 206 patients with early breast cancer were recruited. Tc and patent blue were administered in standard fashion. Patients were injected with SPIO (Sienna+) preoperatively. SNB was performed and detection rates were recorded for both methods. Skin discoloration was followed and documented postoperatively. Data extraction and subsequent meta-analysis of all previous studies were also performed. SN detection rates were similar between standard technique succeeded and SPIO both per patient (97.1 vs. 97.6 %, p  = 0.76) as well as per node (91.3 vs. 93.3 %, p  = 0.34), something which was not affected by the presence of malignancy. Concordance rates were also consistently high (98.0 % per patient and 95.9 % per node). Discoloring was present in 35.5 % of patients postoperatively, almost exclusively in breast conservation. It fades slowly and is still detectable in 8.6 % of patients after 15 months. Meta-analysis depicted similar detection rates ( p  = 0.71) and concordance rates ( p  = 0.82) per patient. However, it seems that SPIO is characterized by higher nodal retrieval ( p  < 0.001). SPIO is an effective method for the detection of SN in patients with breast cancer. It is comparable to the standard technique and seems to simplify logistics. Potential skin discoloration is something of consideration in patients planned for breast conservation.
Author Jørnsgård, Hjørdis
Markopoulos, Christos J.
Fischer, Lone
Bergkvist, Leif
Rasmussen, Nils Ryegaard
Daskalakis, Kosmas
Christiansen, Peer Michael
Hedin, Christina
Tegnelius, Daniel
Wärnberg, Fredrik
Sund, Malin
Pistioli, Lida
Eriksson, Staffan
Karakatsanis, Andreas
Author_xml – sequence: 1
  givenname: Andreas
  surname: Karakatsanis
  fullname: Karakatsanis, Andreas
  email: andreas.karakatsanis@akademiska.se
  organization: Section for Endocrine and Breast Surgery, Department of Surgical Sciences, Uppsala University Hospital
– sequence: 2
  givenname: Peer Michael
  surname: Christiansen
  fullname: Christiansen, Peer Michael
  organization: Breast Unit, Department of Surgery, Aarhus University Hospital/Randers Regional Hospital
– sequence: 3
  givenname: Lone
  surname: Fischer
  fullname: Fischer, Lone
  organization: Breast Unit, Department of Surgery, Aarhus University Hospital/Randers Regional Hospital
– sequence: 4
  givenname: Christina
  surname: Hedin
  fullname: Hedin, Christina
  organization: Breast Unit, Department of Surgery, Linköping University Hospital
– sequence: 5
  givenname: Lida
  surname: Pistioli
  fullname: Pistioli, Lida
  organization: Breast Unit, Department of Surgery, Linköping University Hospital
– sequence: 6
  givenname: Malin
  surname: Sund
  fullname: Sund, Malin
  organization: Department of Surgical and Perioperative Sciences
– sequence: 7
  givenname: Nils Ryegaard
  surname: Rasmussen
  fullname: Rasmussen, Nils Ryegaard
  organization: Breast Unit, Department of Surgery, SVS
– sequence: 8
  givenname: Hjørdis
  surname: Jørnsgård
  fullname: Jørnsgård, Hjørdis
  organization: Breast Unit, Department of Surgery, SVS
– sequence: 9
  givenname: Daniel
  surname: Tegnelius
  fullname: Tegnelius, Daniel
  organization: Breast Unit, Department of Surgery, Örebro University Hospital
– sequence: 10
  givenname: Staffan
  surname: Eriksson
  fullname: Eriksson, Staffan
  organization: Department of Surgery, Västmanland County Hospital
– sequence: 11
  givenname: Kosmas
  surname: Daskalakis
  fullname: Daskalakis, Kosmas
  organization: Section for Endocrine and Breast Surgery, Department of Surgical Sciences, Uppsala University Hospital
– sequence: 12
  givenname: Fredrik
  surname: Wärnberg
  fullname: Wärnberg, Fredrik
  organization: Section for Endocrine and Breast Surgery, Department of Surgical Sciences, Uppsala University Hospital
– sequence: 13
  givenname: Christos J.
  surname: Markopoulos
  fullname: Markopoulos, Christos J.
  organization: Medical School, National and Kapodistrian University
– sequence: 14
  givenname: Leif
  surname: Bergkvist
  fullname: Bergkvist, Leif
  organization: Center for Clinical Research Uppsala University and Department of Surgery, Västmanland County Hospital
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Issue 2
Keywords Sentinel node
Breast cancer
Super paramagnetic iron oxide
Language English
License Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
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PublicationTitle Breast cancer research and treatment
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Snippet The aim of the study is to compare the efficacy of SPIO as a tracer in sentinel node biopsy (SNB) in breast cancer with Tc and patent blue in a multicentre...
SourceID pubmedcentral
crossref
springer
SourceType Open Access Repository
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StartPage 281
SubjectTerms Clinical Trial
Medicine
Medicine & Public Health
Oncology
Title The Nordic SentiMag trial: a comparison of super paramagnetic iron oxide (SPIO) nanoparticles versus Tc99 and patent blue in the detection of sentinel node (SN) in patients with breast cancer and a meta-analysis of earlier studies
URI https://link.springer.com/article/10.1007/s10549-016-3809-9
https://pubmed.ncbi.nlm.nih.gov/PMC4875068
Volume 157
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