RT Journal Article SR Electronic T1 Sentinel Lymph Node Biopsy in breast cancer with 99mTc-Tilmanocept: A novel tracer in the real life. A multicenter study JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP jnumed.120.252064 DO 10.2967/jnumed.120.252064 A1 Sergi Vidal-Sicart A1 María Eugenia Rioja A1 Andrea Prieto A1 Elena Goñi A1 Isabel Gómez A1 María Dolores Albala A1 Luis Lumbreras A1 Luisa Fernanda León A1 José Ramón Gómez A1 Francisco Campos YR 2020 UL http://jnm.snmjournals.org/content/early/2020/10/09/jnumed.120.252064.abstract AB 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.