PT  - JOURNAL ARTICLE
AU  - Henry W.D. Yeung
AU  - Hiram S. Cody III
AU  - Alla Turlakow
AU  - Elyn R. Riedel
AU  - Jane Fey
AU  - Mithat Gonen
AU  - Rodolfo Nuñez
AU  - Samuel D. Yeh
AU  - Steven M. Larson
TI  - Lymphoscintigraphy and Sentinel Node Localization in Breast Cancer Patients: A Comparison Between 1-Day and 2-Day Protocols
DP  - 2001 Mar 01
TA  - Journal of Nuclear Medicine
PG  - 420--423
VI  - 42
IP  - 3
4099  - http://jnm.snmjournals.org/content/42/3/420.short
4100  - http://jnm.snmjournals.org/content/42/3/420.full
SO  - J Nucl Med2001 Mar 01; 42
AB  - The purpose of this study was to compare the results of isotope injection the morning of surgery (1-d protocol) with isotope injection the day before surgery (2-d protocol) in patients having sentinel lymph node (SLN) biopsy for breast cancer. Methods: The 1-d (protocol 1) and 2-d (protocol 2) protocols included 514 and 152 patients, respectively, treated contemporaneously by surgeons experienced with the SLN biopsy technique. All had preoperative lymphoscintigraphy (LSG) and SLN biopsy using both blue dye and 99mTc–sulfur colloid. All patients had a single-site intradermal injection of unfiltered 99mTc–sulfur colloid in 0.05 mL normal saline: 3.7 MBq (0.1 mCi) on the morning of surgery for protocol 1 and 18.5 MBq (0.5 mCi) on the afternoon before surgery for protocol 2. Results: The patients in protocols 1 and 2 were comparable in terms of age, tumor size, tumor location, histologic type, node positivity, and frequency of a previous surgical biopsy. Comparing protocols 1 and 2, early (30 min) LSG images found the SLN equally often (69% vs. 68%). Isotope identified the SLN equally often at surgery (93% vs. 97%) as did isotope plus dye (98% vs. 99%). A comparable number of SLNs was found (2.5 vs. 2.8 per axilla), and the concordance between isotope and dye in the SLN was also comparable (97% vs. 95%). Late LSG images (at 2 h, possible only for protocol 2) identified the SLN in significantly more patients compared with early images (86% vs. 68%). Conclusion: With unfiltered 99mTc–sulfur colloid injected intradermally, the results of SLN biopsy under the 1-d and 2-d protocols are virtually identical. A 2-d protocol allows increased efficiency in scheduling, both for nuclear medicine physicians and for the operating room, with no compromise in the effectiveness of SLN mapping.