Document Detail

Safety of sentinel node biopsy in breast cancer patients who receive a second radioisotope injection after visualization failure in lymphoscintigraphy.
MedLine Citation:
PMID:  20976732     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVES: A failure to visualize axillary sentinel nodes in lymphoscintigraphy may lead to an unsuccessful sentinel node biopsy (SNB) and subsequent axillary lymph node dissection (ALND). To avoid unnecessary ALND, a second radioisotope injection may be given but has been considered hazardous. We investigated the axillary recurrence rate after tumor-negative SNB in breast cancer patients who received a second tracer injection after axillary visualization failure in lymphoscintigraphy.
METHODS: Altogether 1,309 breast cancer patients who underwent a tumor-negative SNB without an ALND were included. Two hundred seven (15.8%) patients received a second tracer injection due to visualization failure in lymphoscintigraphy and 1,102 (84.2%) did not. All patients received a blue dye injection prior to the SNB. The median follow-up time was 43 months.
RESULTS: No isolated cancer recurrences were diagnosed in the ipsilateral axilla among patients who received two radioisotope injections. Disease-free survival and overall survival were similar among patients with one or two radioisotope injections (P = 0.122 and P = 0.200, respectively).
CONCLUSIONS: Additional radiocolloid tracer injection after axillary non-visualization in lymphoscintigraphy is safe and does not increase axillary recurrence risk after tumor-negative SNB. The results suggest that such patients can be safely managed with SNB without a need to perform an ALND.
Tuomo J Meretoja; Heikki Joensuu; Päivi S Heikkilä; Marjut H Leidenius
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of surgical oncology     Volume:  102     ISSN:  1096-9098     ISO Abbreviation:  J Surg Oncol     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-26     Completed Date:  2010-12-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0222643     Medline TA:  J Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  649-55     Citation Subset:  IM    
Breast Surgery Unit, Helsinki University Central Hospital, Helsinki, Finland.
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MeSH Terms
Aged, 80 and over
Breast Neoplasms / pathology*
Injections / adverse effects*
Lymph Nodes / radionuclide imaging*
Lymphatic Metastasis / radionuclide imaging*
Middle Aged
Preoperative Care
Radioisotopes / administration & dosage*,  adverse effects,  diagnostic use
Sentinel Lymph Node Biopsy / methods*
Treatment Failure
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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