Breast Clinic, Istanbul Oncology Hospital, İstanbul, Turkey.
Department of General Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
J Invest Surg. 2022 Jun;35(6):1275-1278. doi: 10.1080/08941939.2022.2038737. Epub 2022 Feb 17.
Optimal axillary staging after neoadjuvant chemotherapy (NAC) in node-negative breast cancer is an area of controversy. Sentinel node biopsy with Technetium-sulphur colloid (99m Tc) alone or with blue dye is the recommended technique for evaluating axilla in these patients. However, this technique has drawbacks such as limited access to nuclear departments and timing limitations related to Tc injection exposing patients to unnecessary radiation. Superparamagnetic iron oxide nanoparticles (SPIO) may represent a valid option for SLN biopsy. In this study, we assessed the feasibility of the magnetic technique (Sentimag) with combination of isosulfan blue dye in breast cancer patients who received NAC.
The study sample consisted of 54 female breast cancer patients who received NAC. Sentinel node localization was performed using magnetic technique and blue dye. Sentinel node identification rate (IFR) of magnetic technique was calculated and postoperative complications were assessed.
Sentinel lymph node was detected in 52 patients with Sentimag method (identification rate = 96.3%, 95% CI: 87.4-98.9%). Blue dye was successful to find SLN in 38 patients (identification rate = 70%). The most common histologic type was invasive ductal ( = 51; 94.4%). Mean tumor size was 2.1 cm after NAC. Most of patients had T2 ( = 30; 55.5%) and HER2 + positive ( = 49; 90.7%) cancer.
Sentimag which is a magnetic technique appears to be safe, easy to perform with minimal adverse effects, may be an alternative and accurate technique in patients with NAC, especially in breast units where nuclear medicine unit is not available.
Supplemental data for this article is available online at https://doi.org/10.1080/08941939.2022.2038737 .
新辅助化疗（NAC）后腋窝淋巴结阴性乳腺癌的最佳分期是一个有争议的领域。单独使用锝-硫胶体（99mTc）或联合使用蓝染料的前哨淋巴结活检是评估这些患者腋窝的推荐技术。然而，该技术存在一些缺点，如核医学部门的访问受限以及与 Tc 注射相关的时间限制，使患者暴露于不必要的辐射下。超顺磁氧化铁纳米颗粒（SPIO）可能是前哨淋巴结活检的一种有效选择。在这项研究中，我们评估了接受 NAC 的乳腺癌患者中磁性技术（Sentimag）联合异硫蓝染料进行 SLN 活检的可行性。
研究样本包括 54 名接受 NAC 的女性乳腺癌患者。使用磁性技术和蓝染料进行前哨淋巴结定位。计算磁性技术的前哨淋巴结识别率（IFR）并评估术后并发症。
Sentimag 方法检测到 52 例患者的前哨淋巴结（识别率=96.3%，95%CI：87.4-98.9%）。蓝染料成功定位 SLN 于 38 例患者（识别率=70%）。最常见的组织学类型是浸润性导管癌（ =51；94.4%）。NAC 后平均肿瘤大小为 2.1cm。大多数患者为 T2（ =30；55.5%）和 HER2阳性（ =49；90.7%）癌症。
Sentimag 是一种磁性技术，似乎是安全的，易于操作，副作用最小，可能是 NAC 患者的一种替代和准确技术，特别是在没有核医学部门的乳腺单位。
本文的补充数据可在 https://doi.org/10.1080/08941939.2022.2038737 在线获取。
