Annals of Surgical Oncology

, Volume 21, Issue 4, pp 1237–1245

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

  • Michael Douek
  • Joost Klaase
  • Ian Monypenny
  • Ashutosh Kothari
  • Katalin Zechmeister
  • Douglas Brown
  • Lynda Wyld
  • Philip Drew
  • Hans Garmo
  • Olorunsola Agbaje
  • Quentin Pankhurst
  • Bauke Anninga
  • Maarten Grootendorst
  • Bennie ten Haken
  • Margaret A. Hall-Craggs
  • Arnie Purushotham
  • Sarah Pinder
  • On behalf of the SentiMAG Trialists Group
Breast Oncology

DOI: 10.1245/s10434-013-3379-6

Cite this article as:
Douek, M., Klaase, J., Monypenny, I. et al. Ann Surg Oncol (2014) 21: 1237. doi:10.1245/s10434-013-3379-6

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.

Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Michael Douek
    • 1
    • 2
  • Joost Klaase
    • 3
  • Ian Monypenny
    • 4
  • Ashutosh Kothari
    • 2
  • Katalin Zechmeister
    • 5
  • Douglas Brown
    • 6
  • Lynda Wyld
    • 7
  • Philip Drew
    • 8
  • Hans Garmo
    • 1
  • Olorunsola Agbaje
    • 1
  • Quentin Pankhurst
    • 9
  • Bauke Anninga
    • 1
    • 10
  • Maarten Grootendorst
    • 1
    • 10
  • Bennie ten Haken
    • 10
  • Margaret A. Hall-Craggs
    • 11
  • Arnie Purushotham
    • 1
    • 2
  • Sarah Pinder
    • 1
    • 2
  • On behalf of the SentiMAG Trialists Group
  1. 1.Division of Cancer Studies, Department of Research OncologyKing’s College LondonLondonUK
  2. 2.Guy’s & St. Thomas’ Hospitals NHS Foundation TrustLondonUK
  3. 3.Medisch Spectrum TwenteEnschedeThe Netherlands
  4. 4.University Hospital of Wales at LlandoughCardiffUK
  5. 5.Norwich and Norfolk University HospitalsNorwichUK
  6. 6.Ninewells Hospital and Medical SchoolDundeeUK
  7. 7.University of SheffieldSheffieldUK
  8. 8.Royal Cornwall Hospitals NHS TrustTruroUK
  9. 9.University College LondonLondonUK
  10. 10.University of TwenteEnschedeThe Netherlands
  11. 11.University College HospitalLondonUK