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Tc-99m Diphosphonate as a Potential Radiotracer to Detect Sentinel Lymph Nodes in Patients with Breast Cancer

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Abstract

Purpose

To evaluate the potential of Tc-99m diphosphonate as a tracer for sentinel lymph node biopsy in breast cancer.

Methods

Lymphoscintigraphs of 35 patients (50.9 ± 10.2 years) with breast cancer were acquired after administering a subareolar intradermal injection of Tc-99m diphosphonate 18 h before surgery. Static images were taken within 15 min (early phase) and 15 h after injection (delayed phase). The lymphoscintigraphic identification rate was defined as the percentage of subjects studied with visible foci at axillae. Sentinel lymph node biopsies were performed using a gamma probe and by blue dye injection. Any node that was radioactive or stained with blue dye was labeled as a sentinel lymph node. Lymph nodes without radioactivity or blue dye staining were defined as non-sentinel lymph nodes. The intraoperative identification rate was defined as the percentage of patients with a radioactive sentinel lymph node. Percentages of lymphoid cells expressing S-100, CD83, and CD1a were compared.

Results

The lymphoscintigraphic identification rate was 94.3% (33/35) during the early phase and 96.9% (31/32) during the delayed phase, whereas the intraoperative identification rate was 94.3% (33/35). The mean percentages of lymphoid cells that stained positively for S-100 or CD83 were lower in sentinel lymph nodes than in non-sentinel lymph nodes (1.5% vs. 9.0% for S-100, and 4.5% vs. 9.3% for CD83, respectively, p = 0.0286). The mean percentages of lymphoid cells in sentinel lymph nodes and non- sentinel lymph nodes expressing CD1a were 3.3% and 7.0%, respectively (p = ns).

Conclusions

Tc-99m diphosphonate can reliably detect regional lymph nodes in breast cancer.

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Acknowledgement

This work was supported by the Korea Research Foundation Grant funded by the Korean Society of Nuclear Medicine

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Authors and Affiliations

  1. Department of Nuclear Medicine, Medical College of Kyung Hee University, 149 Sang-Il-dong, Kangdong-gu, Seoul, 134-727, South Korea

    You-Jung Yang

  2. Department of Pathology, Medical College of Kyung Hee University, Seoul, Korea

    Sung-Jig Lim

  3. Department of Surgery, Medical College of Kyung Hee University, Seoul, Korea

    Jeong-Yoon Song

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  1. You-Jung Yang
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  2. Sung-Jig Lim
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Correspondence to You-Jung Yang.

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Yang, YJ., Lim, SJ. & Song, JY. Tc-99m Diphosphonate as a Potential Radiotracer to Detect Sentinel Lymph Nodes in Patients with Breast Cancer. Nucl Med Mol Imaging 44, 62–68 (2010). https://doi.org/10.1007/s13139-009-0002-7

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  • DOI: https://doi.org/10.1007/s13139-009-0002-7

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