Failure predictors of the sentinel lymph node in patients with breast cancer using Tc-99m sulfur colloid and periareolar injection.

Abstract

AIM:

As sentinel lymph node (SLN) experience rises, it is important to identify factors that can limit lymphoscintigraphic mapping.

METHODS:

A prospective study was conducted with breast cancer patients that were submitted to sentinel node mapping by lymphoscintigraphy between October 2003 and January 2005. The analyzed factors were: patients' age, body mass index, tumor size, previous breast surgeries, time between a previous biopsy and the radiotracer injection and their impact on preoperative SLN identification.

RESULTS:

Two hundred and three breast cancer patients were injected with (99m)Technetium-sulfur colloid and submitted to lymphoscintigraphy scan for SLN biopsy. One hundred and eighty-four of these patients (90.64%) had a successfully identified SLN and 19 (9.36%) had a mapping failure. The median age of the successful group was 55.6 years and in the failure group was 57.1 years (P=0.002). The median body mass index was 25.3 and 27.6, respectively (P=0.024). The tumor size did not show any significant difference between the patients with successful mapping and failure (P=0.07). Previous breast surgery was an important limiting factor for SLN mapping (P=0.017). The mean time from biopsy to SLN detection was 23.6 days on the successfully marked patients and 17.4 days in the failure group (P<0.0001). All the 184 successfully mapped patients had the SLN identified. Only one patient of the failure group had the SLN identified using blue dye.

CONCLUSION:

Advanced age, elevated body mass index, previous breast surgery and a shorter period of time after a breast biopsy are causes for SLN identification failure. The tumor size was not a limiting factor.

• Authors: C Pritsivelis, C A Garcia Mendonça, M C Pinheiro Pessoa, A Coelho-Oliveira, B Gutfilen, L M Barbosa Da Fonseca
• Journal: The quarterly journal of nuclear medicine and molecular imaging : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of... (Q J Nucl Med Mol Imaging) Vol. 51 Issue 2 Pg. 189-93 (Jun 2007) ISSN: 1824-4785 [Print] Italy
• PMID: 17420718 (Publication Type: Journal Article)

Chemical References

• Radiopharmaceuticals
• Technetium Tc 99m Sulfur Colloid

Topics

• Adult
• Aged
• Aged, 80 and over
• Breast Neoplasms (diagnostic imaging, pathology)
• Diagnostic Errors (prevention & control)
• Female
• Humans
• Injections, Intralesional
• Lymph Nodes (diagnostic imaging, pathology)
• Lymphatic Metastasis
• Male
• Middle Aged
• Radionuclide Imaging
• Radiopharmaceuticals (administration & dosage)
• Reproducibility of Results
• Sensitivity and Specificity
• Sentinel Lymph Node Biopsy (methods)
• Technetium Tc 99m Sulfur Colloid (administration & dosage)