Sentinel Lymph Node Biopsy in Early Breast Cancer: Magnetic Tracer as the Only Localizing Agent.
Adult
Aged
Aged, 80 and over
Breast Neoplasms
/ pathology
Female
Ferric Compounds
Humans
Lymph Node Excision
Lymphatic Metastasis
/ diagnosis
Magnetics
Mastectomy, Segmental
Middle Aged
Neoplasm Micrometastasis
/ diagnosis
Retrospective Studies
Sentinel Lymph Node
/ pathology
Sentinel Lymph Node Biopsy
/ methods
Journal
World journal of surgery
ISSN: 1432-2323
Titre abrégé: World J Surg
Pays: United States
ID NLM: 7704052
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
pubmed:
20
3
2019
medline:
26
11
2019
entrez:
20
3
2019
Statut:
ppublish
Résumé
The combined use of radioisotope and blue dye is the gold standard in sentinel lymph node (SLN) localization in early breast cancer. Superparamagnetic iron oxide (SPIO) has recently emerged as a non-inferior new tracer in sentinel lymph node mapping with fewer disadvantages. This study represents the first and the largest cohort of superparamagnetic iron oxide application in Asian population. Retrospective analysis of a prospectively maintained database was performed from August 2016 to December 2017. All patients with SLN localization by SPIO were included in this study. A total of 328 breast cancer patients with 333 SLNB procedures were included in this study. Median age was 54 years (range 32-86). Median tumor size was 1.9 cm (range 0.1-12 cm).There were 138 breast-conserving surgeries and 195 mastectomies. All patients received injection of SPIO 1 day prior to operation. A total of 329 successful sentinel lymph node biopsy (SLNB) procedures were undertaken with 1514 sentinel lymph nodes (SLNs) identified. One hundred and fifty-three (10.1%) of the SLNs were positive for malignancy. There were 54 patients with macrometastases, 26 with micrometastases and 24 with isolated tumor cells. Sixty-seven patients underwent subsequent axillary dissection. Four patients failed sentinel lymph node identification with SPIO. The success rate of SPIO in sentinel lymph node localization was 98.8%. SPIO represents a feasible alternative in sentinel lymph node mapping with comparably high nodal detection rate.
Sections du résumé
BACKGROUND
The combined use of radioisotope and blue dye is the gold standard in sentinel lymph node (SLN) localization in early breast cancer. Superparamagnetic iron oxide (SPIO) has recently emerged as a non-inferior new tracer in sentinel lymph node mapping with fewer disadvantages. This study represents the first and the largest cohort of superparamagnetic iron oxide application in Asian population.
METHODS
Retrospective analysis of a prospectively maintained database was performed from August 2016 to December 2017. All patients with SLN localization by SPIO were included in this study.
RESULTS
A total of 328 breast cancer patients with 333 SLNB procedures were included in this study. Median age was 54 years (range 32-86). Median tumor size was 1.9 cm (range 0.1-12 cm).There were 138 breast-conserving surgeries and 195 mastectomies. All patients received injection of SPIO 1 day prior to operation. A total of 329 successful sentinel lymph node biopsy (SLNB) procedures were undertaken with 1514 sentinel lymph nodes (SLNs) identified. One hundred and fifty-three (10.1%) of the SLNs were positive for malignancy. There were 54 patients with macrometastases, 26 with micrometastases and 24 with isolated tumor cells. Sixty-seven patients underwent subsequent axillary dissection. Four patients failed sentinel lymph node identification with SPIO. The success rate of SPIO in sentinel lymph node localization was 98.8%.
CONCLUSION
SPIO represents a feasible alternative in sentinel lymph node mapping with comparably high nodal detection rate.
Identifiants
pubmed: 30888473
doi: 10.1007/s00268-019-04977-1
pii: 10.1007/s00268-019-04977-1
doi:
Substances chimiques
Ferric Compounds
0
ferric oxide
1K09F3G675
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1991-1996Références
Mansel RE, Fallowfield L, Kissin M et al (2006) Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC Trial. J Natl Cancer Inst 98:599–609
doi: 10.1093/jnci/djj158
pubmed: 16670385
Cody HS (2001) Clinical aspects of sentinel node biopsy. Breast Cancer Res 3:104–108
doi: 10.1186/bcr280
pubmed: 11250755
pmcid: 139440
O’Hea BJ, Hill ADK, El-Shirbiny AM et al (1998) Sentinel lymph node biopsy in breast cancer: initial experience at Memorial Sloan-Kettering Cancer Centre. J Am Coll Surg 186(4):423–427
doi: 10.1016/S1072-7515(98)00060-X
pubmed: 9544956
Goyal A, Newcombe RG, Chhabra A et al (2006) Factors affecting failed localisation and false-negative rates of sentinel node biopsy in breast cancer—results of the ALMANAC validation phase. Breast Cancer Res Treat 99:203–208
doi: 10.1007/s10549-006-9192-1
pubmed: 16541308
Reyes FJ, Noelck MB, Valentino C et al (2011) Complications of Methylene blue dye in breast surgery: case reports and review of the literature. J Cancer 2:20–25
doi: 10.7150/jca.2.20
Lyew MA, Gamblin TC, Ayoub M (2000) Systemic anaphylaxis associated with intramammary isosulfan blue injection used for sentinel node detection under general anesthesia. Anesthesiology 93:1145–1146
doi: 10.1097/00000542-200010000-00041
pubmed: 11020773
Kuerer HM, Wayne JD, Ross MI (2001) Anaphylaxis during breast cancer lymphatic mapping. Surgery 129:119–120
doi: 10.1067/msy.2001.111212
pubmed: 11150045
Douek M et al (2014) Sentinel node biopsy using a magnetic tracer versus standard technique: the SentiMAG Multicentre Trial. Ann Surg Oncol 21(4):1237–1245
doi: 10.1245/s10434-013-3379-6
pubmed: 24322530
Thill M et al (2014) The Central-European SentiMag study: sentinel lymph node biopsy with superparamagnetic iron oxide (SPIO) vs. radioisotope. Breast 23(2):175–179
doi: 10.1016/j.breast.2014.01.004
pubmed: 24484967
Pinero-Madrona A et al (2015) Superparamagnetic iron oxide as a tracer for sentinel node biopsy in breast cancer: a comparative non-inferiority study. Eur J Surg Oncol 41(8):1–7
doi: 10.1016/j.ejso.2015.04.017
Houpeau JL et al (2016) Sentinel lymph node identification using superparamagnetic iron oxide particles versus radioisotope: the French Sentimag feasibility trial. J Surg Oncol 113(5):501–507
doi: 10.1002/jso.24164
pubmed: 26754343
Karakatsanis A et al (2016) The Nordic SentiMag trial: a comparison of superparamagnetic iron oxide (SPIO) nanoparticles versus Tc99 and patent blue in the detection of sentinel node (sn) in patients with breast cancer and a meta-analysis of earlier studies. Breast Cancer Res Treat 157:281–294
doi: 10.1007/s10549-016-3809-9
pubmed: 27117158
pmcid: 4875068
Rubio IT et al (2015) The superparamagnetic iron oxide is equivalent to the Tc99 radiotracer method for identifying the sentinel lymph node in breast cancer. Eur J Surg Oncol 41:46–51
doi: 10.1016/j.ejso.2014.11.006
pubmed: 25466980
Veronesi U, Paganelli G, Galimberti V et al (1997) Sentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph-nodes. Lancet 349:1864–1867
doi: 10.1016/S0140-6736(97)01004-0
pubmed: 9217757
Krag D, Weaver D, Ashikaga T et al (1998) The sentinel node in breast cancer A multicenter validation study. New Engl J Med 339:941–946
doi: 10.1056/NEJM199810013391401
pubmed: 9753708
Veronesi U, Paganelli G, Viale G et al (1999) Sentinel lymph node biopsy and axillary dissection in breast cancer: results in a large series. J Natl Cancer Inst 91:368–373
doi: 10.1093/jnci/91.4.368
pubmed: 10050871
Lyman GH, Giuliano AE, Somerfield MR et al (2005) American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol 23:7703–7720
doi: 10.1200/JCO.2005.08.001
Krag DN, Anderson SJ, Julian TB et al (2010) Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinical node negative patients with breast cancer: overall survival findings from the NSABP B-32 randomized phase 3 trial. Lancet Oncol 11:927–933
doi: 10.1016/S1470-2045(10)70207-2
pubmed: 20863759
pmcid: 3041644
Somasundarum SK, Chicken DW, Keshtgar MRS (2007) Detection of the sentinel lymph node in breast cancer. Br Med Bull 84:117–131
doi: 10.1093/bmb/ldm032
Krag DN, Anderson SJ, Julian TB et al (2007) Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinical node-negative breast cancer: results from the NSABP B-32 randomised phase III. Lancet Oncol 8:881–888
doi: 10.1016/S1470-2045(07)70278-4
pubmed: 17851130
Bonneau C, Bendifallah S, Reyal F et al (2015) Association of the number of sentinel lymph nodes harvested with survival in breast cancer. EJSO 41:52–58
doi: 10.1016/j.ejso.2014.11.004
pubmed: 25466979
Ghilli M et al (2017) The superparamagnetic iron oxide tracer: a valid alternative in sentinel lymph node biopsy for breast cancer treatment. Eur J Cancer Care 26(4):1–7
doi: 10.1111/ecc.12385