Abstract
Purpose: 99mTc-Tilmanocept is a novel radiopharmaceutical for SLN biopsy in breast cancer. The aim was to describe the results with 99mTc-Tilmanocept in a heterogeneous group of breast cancer patients scheduled for SLN biopsy. Methods: Radiotracer preparation followed the manufacturer’s indications. Local protocols for SLN detection within 9 participant centers were not changed for the entire duration of the study. Three hundred and forty-four patients with T1-T4, N0-N2 breast cancer (352 lesions) were included. Superficial (intradermal-periareolar) or deep (peritumoral-intratumoral) injections were performed. The doses were adjusted depending on the scheduled time for surgery. Results: Lymphoscintigraphy was able to depict at least one SLN in 339 out of 352 breast lesions (96.3%); and intraoperative SLN detection rate reached 97.2%. On univariable analysis, SLN detection rates did not differ by age, clinical T or N stage, tumor location, histologic subtype or prior neoadjuvant therapy. Lymphoscintigraphy showed higher SLN detection in patients with normal weight (BMI<25) than in those with Overweight/Obesity (BMI ≥ 25); 99.2% vs. 94.6%, respectively (P = 0.031). The proportion of patients with preoperative lymphoscintigraphic detection and/or excised SLN was higher with superficial than deep injections. Reinjected cases were significantly lower when superficial injection was firstly chosen (p<0.001). Site of injection and tumor markers Her2 and RE demonstrated impact over preoperative SLN visualization and intraoperative localization. In 80 cases SLN resulted in a positive lymph node. After a mean follow-up of 19 months, no axillary recurrences have been observed. Conclusion: 99mTc-Tilmanocept showed good results whatever protocol was used in a heterogeneous breast cancer population, although the best results were achieved when a superficial injection was done.
- Lymphoscintigraphy
- Oncology: Breast
- axillary staging
- breast cancer
- lymphoscintigraphy
- sentinel node
- tilmanocept
- Copyright © 2020 by the Society of Nuclear Medicine and Molecular Imaging, Inc.