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Clinical Investigations |
-Probes for Sentinel Lymph Node Detection in 200 Breast Cancer Patients
1 Department of Oncological Surgery, René Gauducheau Cancer Center, Saint-Herblain, France
2 Department of Histopathology, Hospital and University Laennec, Saint Herblain, France
3 Department of Nuclear Medicine, René Gauducheau Comprehensive Cancer Center, Saint-Herblain, France
4 Department of Medical Physics, René Gauducheau Cancer Center, Saint-Herblain, France
5 Department of Biostatistics, René Gauducheau Comprehensive Cancer Center, Saint-Herblain, France
6 Institut National de la Santé et de la Recherche Médicale, Unité 463, Nantes, France
Previous reports have shown that axillary sentinel lymph node (ASLN) radiodetection allows accurate axillary staging for patients with early breast cancer. Radioguided surgery implies the use of a 
-probe to count the emitted radioactivity of marked ASLNs. Several -probes are commercially available, each with its own properties. The clinical impact of the type of -probe used for ASLN radiodetection remains to be evaluated. Methods: Three commercially available -probes were evaluated: a scintillator with a bismuth germanate crystal (probe A), a semiconductor with a cadmium telluride crystal (probe B), and a semiconductor with a cadmium zinc telluride crystal (probe C). Two hundred patients with early breast cancer were prospectively enrolled to undergo ASLN radiodetection and axillary lymphadenectomy. ASLN mapping consisted of injecting 99mTc-sulfur-colloid around the tumor. For each patient, sentinel lymph nodes were counted successively with the 3 probes and the sensitivity of each -probe was determined from ASLN residual activity. The results of detection rates and false-negative rates for each probe were compared. Results: Mean residual ASLN activity was 52 kBq (range, 0.07–189 kBq). Sensitivity was compared among the 3 probes and found to be best for probe A. The detection rate of probe A was significantly better than that of probe B (93% vs. 86%, P = 0.05) but not different from that of probe C (93% vs. 90%). No differences in false-negative rates were observed among the 3 probes. Conclusion: ASLN detection rate depends on the type of -probe used. Because failure to detect the ASLN leads to complete axillary lymphadenectomy, involving local morbidity and other sequelae, the type of -probe must be considered important for sentinel lymph node radiodetection.
Key Words: breast cancer • sentinel lymph node • -probe
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