Modification of Lymphoscintigraphy of the Sentinel Node Procedure in Breast Cancer Patients to One Day is Reliable and Effective

Elisabeth RM van Haaren¹*, Nadine S Hillberg¹, Alinda J Muller², Alfred Janssen¹, James van Bastelaar¹ and Yvonne LJ Vissers¹

Received: June 25, 2022;   Published: August 08, 2022

DOI: 10.26717/BJSTR.2022.45.007221

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Abstract

Purpose: In cT1-3N0 breast cancer patients the detection of the sentinel nodes is accomplished by a Technetium -99m (99mTc) nano colloid lymphoscintigraphy in a two-day setting. In the COVID pandemic there was shortage of supportive medical staff and an urge to restrict patient contact. Therefore, we omitted the lymphoscintigraphy on day two. The aim of this study was to examine the reliability of this adjusted protocol.

Methods: Retrospective single-center data analysis of sentinel node biopsies in breast cancer patients in Zuyderland Medical Centre was performed between April 2020 and April 2021. One day before the operation 1cc of 80MBq 99mTc nano colloid was administrated peritumorally and 0,3cc 40MBq 99mTc nano colloid intracutaneously. A dynamical and static early lymphoscintigraphy was performed directly after administration of the tracer. 1cc of patent blue was preoperatively administrated intradermally. Primary outcomes were the number of sentinel lymph nodes on the lymphoscintigraphy and the number found during surgery. Descriptive statics.

Results

194 sentinel node procedures were performed, showing 223 sentinel nodes on lymphoscintigraphy, with a non-visualization ratio of 6 %. 253 lymph nodes were surgically removed, with an average 1.3 node per procedure, and a detection rate of 100%. In four procedures the lymph node was only spotted by blue dye.

Conclusion

Omitting the delayed lymphoscintigraphy on the second day proved to be as reliable and effective as performing both an early and delayed lymphoscintigraphy. A non-visualization ratio of 6 % and a surgical detection ratio of 100% is in line with the results showed in the literature.

Keywords: Breast Cancer; Sentinel Node Biopsy; Lymphoscintigraphy; Technetium-99m; Radioactive Nano Colloid; Non-Visualization

Abbrevations: SLN: Sentinel Lymph Node; LS: Lymphoscintigraphy