Intra-individual comparison of sentinel lymph node scintigraphy on the day of injection and on the following day in breast cancer

Abstract

Our study demonstrated that for patients undergoing the 2-day protocol for sentinel node procedure in early stage breast cancer, the optimal imaging time would be to perform lymphoscintigraphy 1 h after injection, with the possibility of imaging patients the following day in cases where lymphoscintigraphy was negative.

How long the lymphoscintigraphy imaging should be continued for sentinel lymph node mapping?

“…In three patients, SLN was not detected on 30-min image, and it could not be detected at all even on the delayed images either (up to 180 min). Limited studies also showed that sensitivity of imaging is not significantly different in early and delayed images and almost all of the SLNs are visible on the early images [14][15][16]26]. The type of the radiotracer as well as the optimal time of imaging is largely determined by operating room scheduling.…”

“…Injection site [20] and dose [21], type of the radiotracer [21,22], and patient eligibility are among these controversies [23]. Interestingly, different techniques of SLN biopsy usually have comparable results for reliable SLN detection [14].…”

“…Although single-day (tracer injection and surgery in the same day) and 2-day protocols of SLN biopsy are comparable in success rate [24], many centers prefer 2-day protocol due to prolonged time spending in the nuclear medicine department for lymphoscintigraphy and the resulting difficulties in operating room scheduling [14]. However, the radiotracer dose in the 2-day protocol is higher (with resulting higher radiation to the patient) and count rate of the SLN during surgery is lower [25].…”

“…To date, very limited studies evaluated the need for delayed imaging and the difference between early and delayed image sets [14][15][16]. The value of continuing the imaging for a prolonged period of time, especially for the patients in which SLN was not detected on the early images and the question of how long shall we continue imaging in this condition, has not been addressed enough in the literature.…”

Comparison of subareolar injection lymphoscintigraphy with the 1-day and the 2-day protocols for the detection of sentinel lymph nodes in patients with breast cancer

“…Because of time constraints the coordination of lymphoscintigraphy with surgery may be difficult to achieve [15][16][17][18]. The results of this study showed that there was a high-identification rate of sentinel lymph nodes, 91.1% by lymphoscintigraphy and 89.7% by gamma probe with the 1 day protocol.…”