ABSTRACT
PURPOSE: To evaluate the influence of a second radioisotope injection on the intraoperative success rate in patients with non-visualized axillary sentinel nodes (SN). MATERIAL AND METHODS: Altogether, 534 consecutive breast cancer patients with lymphoscintigraphy (LS) and SN biopsy and were included. An intratumoral injection of 99mTc-labeled human albumin colloid with a median dose of 93 MBq was applied. Forty-two of the 80 patients without axillary hot spots on LS received a second tracer injection with a median dose of 70 MBq. RESULTS: The visualization rate of axillary SN was 454/534 (85%). The intraoperative SN identification rate was 97% in patients with and 69% in patients without visualized SN in the axilla (P<0.00005), but the success rate was higher (88%) with a second radioisotope injection than without it (47%; P<0.0002). CONCLUSION: The failure rate in intraoperative SN identification was minimized using a second radioisotope injection in patients without axillary SN on LS.
Subject(s)
Breast Neoplasms/diagnostic imaging , Breast Neoplasms/surgery , Lymph Nodes/diagnostic imaging , Adult , Aged , Aged, 80 and over , Axilla , Female , Humans , Intraoperative Period , Middle Aged , Radionuclide Imaging , Technetium Tc 99m Aggregated AlbuminABSTRACT
PURPOSE: To investigate whether the visualization of axillary sentinel nodes (SN) in the lymphoscintigraphy (LS) can be enhanced by adjusting the amount of radioactivity in accordance with the patient's body mass index (BMI). MATERIAL AND METHODS: Group I consisted of 356 consecutive breast cancer patients who underwent LS and SN biopsy after a single, intratumoral radioactive tracer injection with a median dose of 92 MBq. In group II (178 consecutive patients), the dose of the tracer was adjusted according to BMI; 80, 100, or 140 MBq. RESULTS: The visualization rate of axillary SN was 86% in group I and 83% in group II (P = 0.303). In patients with BMI >30 with visualized axillary SN, the median number of SN was 1 (1-4) in group I and 3 (1-7) in group II (P = 0.002). CONCLUSION: Adjusting the tracer dose in accordance with patient BMI did not enhance the visualization rate of axillary SN in LS.
