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Mammary lymphoscintigraphy with various radiopharmaceuticals in breast cancer

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Abstract

Sentinel node biopsy (SNB) in breast cancer is a promising surgical technique that avoids unnecessary axillary lymph node dissection. To optimize lymphatic mapping with radiopharmaceuticals, mammary lymphoscintigraphy with 30–50 MBq of technetium-99m-diethylenetriamine pentaacetic acid human serum albumin (99mTc-HSAD), technetium-99m-human serum albumin (99mTc-HSA), or technetium-99m-tin colloid (99mTc-TC) were investigated in 69 cases of primary breast cancer. Dynamic early images were obtained during the first 30 or 40 minutes, and static delayed images were obtained 6 hours after tracer injection. Hot spots as sentinel lymph nodes (SLNs) appeared in 51 of 69 cases (74%): in early images in 27 cases and in delayed images in 24 cases. SLNs were visualized more frequently in 23 of the 26 cases (88%) treated with99mTc-HSAD and in 21 of the 24 cases (88%) treated with99mTc-HSA than in only 7 of the 19 cases (37%) treated with99mTc-TC. In 26 of the 51 cases, SLNs were identified as faint spots in delayed images. There was a significant difference in the first appearance of SLNs on the lymphoscintiscan between 43 cases of dense breast parenchyma and 26 cases of fatty breast parenchyma. These results suggest that99mTc-HSAD or99mTc-HSA is acceptable for lymphatic mapping, but in cases which have faint spots in delayed images or fatty breast parenchyma, gamma probe-guided SNB may result in failure or misleading false-negative SLNs.

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References

  1. Cabanas RM. An approach for the treatment of penile carcinoma.Cancer 39: 456–466, 1977.

    Article  PubMed  CAS  Google Scholar 

  2. Morton DL, Wen DR, Wong JH, Economou JS, Cagle LA, Storm FK, et al. Technical details of intraoperative lymphatic mapping for early stage melanoma.Arch Surg 127: 392–399, 1992.

    PubMed  CAS  Google Scholar 

  3. Krag DN, Weaver DL, Alex JC, Fairbank JT. Surgical resection and radiolocalization of the sentinel lymph node in breast cancer using a gamma probe.Surg Oncol 2: 335–340, 1993.

    Article  PubMed  CAS  Google Scholar 

  4. Imoto S, Hasebe T. Initial experience of sentinel node biopsy in breast cancer at the National Cancer Center Hospital East.Jpn J Clin Oncol 29: 11–15, 1999.

    Article  PubMed  CAS  Google Scholar 

  5. Whitehead J, Carlile T, Kopecky KJ, Thompson DJ, Gilbert FI, Present AJ, et al. Wolfe mammographic parenchymal patterns.Cancer 56: 1280–1286, 1985.

    Article  PubMed  CAS  Google Scholar 

  6. Albertini JJ, Lyman GH, Cox C, Yeatman T, Balducci L, Ku N, et al. Lymphatic mapping and sentinel node biopsy in the patient with breast cancer.J Am Med Assoc 276: 1818–1822, 1996.

    Article  CAS  Google Scholar 

  7. Veronesi U, Paganelli G, Galimberti V, Viale G, Zurrida S, Bedoni M, et al. Sentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph-nodes.Lancet 349: 1864–1867, 1997.

    Article  PubMed  CAS  Google Scholar 

  8. Pijpers R, Meijer S, Hoekstra OS, Collet GJ, Comans EFI, Boom RPA, et al. Impact of lymphoscintigraphy on sentinel node identification with Technetium-99m-colloidal albumin in breast cancer.J Nucl Med 38: 366–368, 1997.

    PubMed  CAS  Google Scholar 

  9. Galimberti V, Zurrida S, Zucali P, Luini A. Can sentinel node biopsy avoid axillary dissection in clinically node-negative breast cancer patients?Breast 7: 8–10, 1998.

    Article  Google Scholar 

  10. O’Hea BJ, Hill ADK, El-Shirbiny AM, Yeh SDJ, Rosen PP, Coit DG, et al. Sentinel lymph node biopsy in breast cancer: Initial experience at Memorial Sloan-Kettering Cancer Center.J Am Coll Surg 186: 423–427, 1998.

    Article  PubMed  Google Scholar 

  11. Borgstein PJ, Pijpers R, Comans EF, van Diest PJ, Boom RP, Meijer S. Sentinel lymph node biopsy in breast cancer: Guidelines and pitfall of lymphoscintigraphy and gamma probe detection.J Am Coll Surg 186: 275–283, 1998.

    Article  PubMed  CAS  Google Scholar 

  12. Cox CE, Pendas S, Cox JM, Joseph E, Shons AR, Yeatman T, et al. Guidelines for sentinel node biopsy and lymphatic mapping of patients with breast cancer.Ann Surg 227: 645–653, 1998.

    Article  PubMed  CAS  Google Scholar 

  13. Barnwell JM, Arredondo MA, Kollmorgen D, Gibbs JF, Lamonica D, Carson W, et al. Sentinel node biopsy in breast cancer.Ann Surg Oncol 5: 126–130, 1998.

    Article  PubMed  CAS  Google Scholar 

  14. Krag D, Weaver D, Ashikaga T, Moffat F, Klimberg VS, Shriver C, et al. The sentinel node in breast cancer.New Engl J Med 339: 941–946, 1998.

    Article  PubMed  CAS  Google Scholar 

  15. Uren RF, Howman-Giles RB, Thompson JF, Malouf D, Ramsey-Stewart G, Niesche FW, et al. Mammary lymphoscintigraphy in breast cancer.J Nucl Med 36: 1775–1780, 1995.

    PubMed  CAS  Google Scholar 

  16. Paganelli G, De Cicco C, Cremonesi M, Prisco G, Calza P, Luini A, et al. Optimized sentinel node scintigraphy in breast cancer.Q J Nucl Med 42: 49–53, 1998.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Breast Surgery, National Cancer Center Hospital East (NCCHE), 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Chiba, Japan

    Shigeru Imoto

  2. Division of Radiology, National Cancer Center Hospital East, Japan

    Kohji Murakami & Hiroshi Ikeda

  3. Division of Radiology, National Cancer Center Hospital, Japan

    Hiroyoshi Fukukita & Noriyuki Moriyama

Authors
  1. Shigeru Imoto
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  2. Kohji Murakami
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  3. Hiroshi Ikeda
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  4. Hiroyoshi Fukukita
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  5. Noriyuki Moriyama
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Correspondence to Shigeru Imoto.

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Imoto, S., Murakami, K., Ikeda, H. et al. Mammary lymphoscintigraphy with various radiopharmaceuticals in breast cancer. Ann Nucl Med 13, 325–329 (1999). https://doi.org/10.1007/BF03164871

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  • DOI: https://doi.org/10.1007/BF03164871

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