Cysteine rhenium colloid: a novel radiocolloid for identifying sentinel lymph nodes in breast cancer surgery.

Abstract

BACKGROUND:

Medical isotopes are required for sentinel node lymphoscintigraphy in breast cancer, but are in critical shortage. Our center uses a modification of the standard SC, called CRC, that has been shown to require less medical isotope for the same procedure. Our objective was to determine if there was a significant difference between SC and CRC in successful lymph node identification in breast cancer patients.

PATIENTS AND METHODS:

This was a retrospective cohort study using prospectively-collected data on 1205 consecutive early, clinically node-negative breast cancer patients who underwent a SNB between 2002 and 2008 at 2 tertiary hospitals in Canada.

RESULTS:

There was no difference in successful lymph node identification rate (P = .50) or in the mean number of positive nodes identified between the 2 colloids (P = .88). The CRC group had a significantly lower rate of delayed adverse events (4.91% vs. 0.59%, P < .0001) even after adjusting for whether axillary dissection occurred on the same day as the biopsy (adjusted odds ratio, 0.12; 95% confidence interval, 0.04-0.40; P = .001).

CONCLUSION:

Our findings suggest that there is no significant difference between CRC and SC in detecting sentinel nodes; however, CRC uses less medical isotopes. In the current climate of critical shortages of medical radioisotopes, radiocolloids should be selected for use based on amount of radioisotope required.

• Authors: Biniam Kidane, Pamela L Zabel, Vaibhav Gupta, Caroline Whiston, Frances Wright, Muriel Brackstone
• Journal: Clinical breast cancer (Clin Breast Cancer) Vol. 15 Issue 1 Pg. e41-5 (Feb 2015) ISSN: 1938-0666 [Electronic] United States
• PMID: 25220300 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Chemical References

• Colloids
• Radioisotopes
• Radiopharmaceuticals
• Rhenium
• Cysteine

Topics

• Aged
• Breast Neoplasms (diagnostic imaging, pathology, surgery)
• Colloids
• Cysteine
• Female
• Humans
• Intraoperative Period
• Lymphatic Metastasis
• Mastectomy
• Middle Aged
• Radioisotopes
• Radionuclide Imaging
• Radiopharmaceuticals
• Retrospective Studies
• Rhenium
• Sentinel Lymph Node Biopsy (methods)