Department of Gynecology with Breast Center, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
Directorate of Charité Center 17, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
Ann Surg Oncol. 2021 Jun;28(6):3232-3240. doi: 10.1245/s10434-020-09280-1. Epub 2020 Dec 1.
Sentinel lymph node biopsy after technetium-99 (Tc) localization is a mainstay of oncologic breast surgery. The timing of Tc injection can complicate operating room schedules, which can cause increasing overall costs of care and patient discomfort.
This study compared 59 patients who underwent breast cancer surgery including sentinel lymph node biopsy. Based on the surgeon's choice, 29 patients were treated with Tc, and 30 patients received the iron-based tracer, Magtrace. The primary outcomes were time spent on the care pathway and operating time from commissioning of the probe to removal of the sentinel node. The secondary outcomes were patient pain levels and reimbursement.
The mean time spent on the preoperative breast cancer care pathway was significantly shorter for the Magtrace group (5.4 ± 1.3 min) than for the Tc group (82 ± 20 min) (p < 0.0001). The median time from probe usage to sentinel node extirpation was slightly but not significantly shorter in the Magtrace group (5 min; interquartile range [IQR], 3-15 min vs 10 min; IQR, 7-15 min; p = 0.151). Reimbursement and pain levels remained unchanged, and the hospital length of stay was similar in the two groups (Magtrace: 5.1 ± 2.3 days vs Tc: 4.5 ± 3.2 days).
Magtrace localization shortened the preoperative care pathway and did not affect surgical time or reimbursement. Once established, it could allow for cost reduction and improve patient comfort.
锝-99(Tc)定位后的前哨淋巴结活检是肿瘤乳房手术的主要方法。Tc 注射的时间会使手术室的日程安排复杂化,这会导致护理总成本增加和患者不适。
本研究比较了 59 例接受乳腺癌手术包括前哨淋巴结活检的患者。根据外科医生的选择,29 例患者接受 Tc 治疗,30 例患者接受铁基示踪剂 Magtrace 治疗。主要结果是护理途径上花费的时间和从探针使用到切除前哨淋巴结的手术时间。次要结果是患者的疼痛程度和报销情况。
Magtrace 组的术前乳腺癌护理途径时间明显短于 Tc 组(5.4±1.3 分钟)(p<0.0001)。Magtrace 组从探针使用到切除前哨淋巴结的中位数时间略短但无统计学意义(5 分钟;四分位距[IQR],3-15 分钟比 10 分钟;IQR,7-15 分钟;p=0.151)。报销和疼痛程度保持不变,两组的住院时间相似(Magtrace:5.1±2.3 天 vs Tc:4.5±3.2 天)。
Magtrace 定位缩短了术前护理途径,并且不影响手术时间或报销。一旦建立,它可以降低成本并提高患者舒适度。