Department of Surgery, Oyama Municipal Hospital, Oyama, Japan.
Breast Cancer. 2013 Jul;20(3):223-9. doi: 10.1007/s12282-011-0327-9. Epub 2012 Jan 13.
Some hospitals lack facilities for radioisotopes in sentinel node biopsy. A novel method is used with a superparamagnetic tracer and a magnetometer instead of a radioisotope.
Thirty patients were included in the study after obtaining IRB approval. Superparamagnetic iron oxide and patent blue dye were injected in the subareolar breast tissue. Following a few minutes of massage to promote migration of the iron tracer and blue dye throughout the lymphatic vessels, the axillary lymph nodes were detected transdermally using a handheld magnetometer and followed by standard axillary dissection in all patients.
Of 30 patients evaluated, sentinel lymph nodes were identified in 90% (27/30) using both blue dye and magnetic tracer. Sentinel lymph nodes were identified using the magnetic method in 23/30 (77%) and blue dye in 24/30 (80%). There was one false-negative sentinel node, resulting in an overall sensitivity of 6/7 (86%).
This is the first study to use a magnetic tracer to identify sentinel lymph nodes in patients with breast cancer. This new technique may alter the role of radioisotopes with further refinement and experience.
一些医院缺乏用于前哨淋巴结活检的放射性同位素设备。本研究采用超顺磁性示踪剂和磁力计替代放射性同位素的新方法。
本研究经 IRB 批准后共纳入 30 例患者。在乳晕下乳腺组织中注射超顺磁性氧化铁和专利蓝染料。在染料和铁示踪剂通过按摩几分钟迁移至淋巴管后，使用手持磁力计经皮检测腋窝淋巴结，并对所有患者进行标准腋窝清扫术。
在评估的 30 例患者中，90%（27/30）的患者通过蓝染和磁示踪均能识别前哨淋巴结。23/30（77%）例患者通过磁法、24/30（80%）例患者通过蓝染法识别出前哨淋巴结。有 1 例前哨淋巴结假阴性，总灵敏度为 6/7（86%）。
这是第一项使用磁性示踪剂来识别乳腺癌患者前哨淋巴结的研究。随着进一步的改进和经验积累，这种新技术可能会改变放射性同位素的作用。
