Breast Oncology

Annals of Surgical Oncology

, Volume 21, Issue 4, pp 1237-1245

First online:

Sentinel Node Biopsy Using a Magnetic Tracer Versus Standard Technique: The SentiMAG Multicentre Trial

  • Michael DouekAffiliated withDivision of Cancer Studies, Department of Research Oncology, King’s College LondonGuy’s & St. Thomas’ Hospitals NHS Foundation Trust Email author 
  • , Joost KlaaseAffiliated withMedisch Spectrum Twente
  • , Ian MonypennyAffiliated withUniversity Hospital of Wales at Llandough
  • , Ashutosh KothariAffiliated withGuy’s & St. Thomas’ Hospitals NHS Foundation Trust
  • , Katalin ZechmeisterAffiliated withNorwich and Norfolk University Hospitals
  • , Douglas BrownAffiliated withNinewells Hospital and Medical School
  • , Lynda WyldAffiliated withUniversity of Sheffield
  • , Philip DrewAffiliated withRoyal Cornwall Hospitals NHS Trust
  • , Hans GarmoAffiliated withDivision of Cancer Studies, Department of Research Oncology, King’s College London
    • , Olorunsola AgbajeAffiliated withDivision of Cancer Studies, Department of Research Oncology, King’s College London
    • , Quentin PankhurstAffiliated withUniversity College London
    • , Bauke AnningaAffiliated withDivision of Cancer Studies, Department of Research Oncology, King’s College LondonUniversity of Twente
    • , Maarten GrootendorstAffiliated withDivision of Cancer Studies, Department of Research Oncology, King’s College LondonUniversity of Twente
    • , Bennie ten HakenAffiliated withUniversity of Twente
    • , Margaret A. Hall-CraggsAffiliated withUniversity College Hospital
    • , Arnie PurushothamAffiliated withDivision of Cancer Studies, Department of Research Oncology, King’s College LondonGuy’s & St. Thomas’ Hospitals NHS Foundation Trust
    • , Sarah PinderAffiliated withDivision of Cancer Studies, Department of Research Oncology, King’s College LondonGuy’s & St. Thomas’ Hospitals NHS Foundation Trust
    • , On behalf of the SentiMAG Trialists Group

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Abstract

Background

The SentiMAG Multicentre Trial evaluated a new magnetic technique for sentinel lymph node biopsy (SLNB) against the standard (radioisotope and blue dye or radioisotope alone). The magnetic technique does not use radiation and provides both a color change (brown dye) and a handheld probe for node localization. The primary end point of this trial was defined as the proportion of sentinel nodes detected with each technique (identification rate).

Methods

A total of 160 women with breast cancer scheduled for SLNB, who were clinically and radiologically node negative, were recruited from seven centers in the United Kingdom and The Netherlands. SLNB was undertaken after administration of both the magnetic and standard tracers (radioisotope with or without blue dye).

Results

A total of 170 SLNB procedures were undertaken on 161 patients, and 1 patient was excluded, leaving 160 patients for further analysis. The identification rate was 95.0 % (152 of 160) with the standard technique and 94.4 % (151 of 160) with the magnetic technique (0.6 % difference; 95 % upper confidence limit 4.4 %; 6.9 % discordance). Of the 22 % (35 of 160) of patients with lymph node involvement, 16 % (25 of 160) had at least 1 macrometastasis, and 6 % (10 of 160) had at least a micrometastasis. Another 2.5 % (4 of 160) had isolated tumor cells. Of 404 lymph nodes removed, 297 (74 %) were true sentinel nodes. The lymph node retrieval rate was 2.5 nodes per patient overall, 1.9 nodes per patient with the standard technique, and 2.0 nodes per patient with the magnetic technique.

Conclusions

The magnetic technique is a feasible technique for SLNB, with an identification rate that is not inferior to the standard technique.