The efficacy of 99mTc-HIG for sentinel lymph node mapping in breast cancer patients

Abstract

To evaluate the efficacy of 99mTc-HIG on SLN identification in patients with early-stage breast cancer.

Seventeen women (18 tumours) with early-stage breast cancer were included. On the day of the operation, 111 MBq 99mTc-HIG was injected around the tumour or biopsy scar in all patients. Subsequently, dynamic lymphoscintigraphic images were taken for 30 min. After this, static images were recorded at 15–20 min intervals until the SLN was visualized. Patients were taken to the operating room 2–4 h after radiopharmaceutical injection. Before the incision, 5 ml of isosulfan blue dye solution was injected peritumourally in all subjects. Aided by blue dye and gamma probe SLN detection was done during the operation.

In 17/18 tumours, SLN was detected with 99mTc-HIG lymphoscintigraphy. The mean visualization time for axillary SLNs was 49.94±11.25 min and for internal mammary SLNs was 52.50±10.60 min. In 15 of the tumours, only one SLN was detected in the axillary region. However, in two tumours, SLNs were found in both axillary and internal mammary regions. With blue dye mapping, axillary SLNs were found in 17/18 tumours. With the application of intraoperative gamma probe, all axillary and internal mammary SLNs were detected in 18 tumours.

We conclude that 99mTc-HIG may be a suitable agent for SLN detection by lymphoscintigraphy and intraoperative gamma probe application in early-stage breast cancer patients.