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Published in: Breast Cancer 3/2013

01-07-2013 | Original Article

Sentinel lymph node biopsy in patients with breast cancer using superparamagnetic iron oxide and a magnetometer

Authors: Mikio Shiozawa, Alan T. Lefor, Yasuo Hozumi, Katsumi Kurihara, Naohiro Sata, Yoshikazu Yasuda, Moriaki Kusakabe

Published in: Breast Cancer | Issue 3/2013

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Abstract

Background

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.

Methods

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.

Results

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%).

Conclusions

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.
Literature
1.
go back to reference Krag DN, Weaver DL, Alex JC, Fairbank JT. Surgical resection and radiolocalization of the sentinel lymph node in breast cancer using a gamma probe. Surg Oncol. 1993;2:335–9.CrossRefPubMed Krag DN, Weaver DL, Alex JC, Fairbank JT. Surgical resection and radiolocalization of the sentinel lymph node in breast cancer using a gamma probe. Surg Oncol. 1993;2:335–9.CrossRefPubMed
2.
go back to reference Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg. 1994;220:391–8.CrossRefPubMed Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg. 1994;220:391–8.CrossRefPubMed
4.
go back to reference Albertini JJ, Lyman GH, Cox C, Yeatman T, Balducci L, Ku N, et al. Lymphatic mapping and sentinel node biopsy in the patient with breast cancer. JAMA. 1996;276:1818–22.CrossRefPubMed Albertini JJ, Lyman GH, Cox C, Yeatman T, Balducci L, Ku N, et al. Lymphatic mapping and sentinel node biopsy in the patient with breast cancer. JAMA. 1996;276:1818–22.CrossRefPubMed
5.
go back to reference Derossis AM, Fey J, Yeung H, Yeh SD, Heerdt AS, Petrek J, et al. A trend analysis of the relative value of blue dye and isotope localization in 2,000 consecutive cases of sentinel node biopsy for breast cancer. J Am Coll Surg. 2001;193:473–8.CrossRefPubMed Derossis AM, Fey J, Yeung H, Yeh SD, Heerdt AS, Petrek J, et al. A trend analysis of the relative value of blue dye and isotope localization in 2,000 consecutive cases of sentinel node biopsy for breast cancer. J Am Coll Surg. 2001;193:473–8.CrossRefPubMed
6.
go back to reference Radovanovic Z, Golubovic A, Plzak A, Stojiljkovic B, Radovanovic D. Blue dye versus combined blue dye-radioactive tracer technique in detection of sentinel lymph node in breast cancer. Eur J Surg Oncol. 2004;30:913–7.PubMed Radovanovic Z, Golubovic A, Plzak A, Stojiljkovic B, Radovanovic D. Blue dye versus combined blue dye-radioactive tracer technique in detection of sentinel lymph node in breast cancer. Eur J Surg Oncol. 2004;30:913–7.PubMed
7.
go back to reference Motomura K, Inaji H, Komoike Y, Hasegawa Y, Kasugai T, Noguchi S, et al. Combination technique is superior to dye alone in identification of the sentinel node in breast cancer patients. J Surg Oncol. 2001;76:95–9.CrossRefPubMed Motomura K, Inaji H, Komoike Y, Hasegawa Y, Kasugai T, Noguchi S, et al. Combination technique is superior to dye alone in identification of the sentinel node in breast cancer patients. J Surg Oncol. 2001;76:95–9.CrossRefPubMed
8.
go back to reference Krag DN, Anderson SJ, Julian TB, Brown AM, Harlow SP, Ashikaga T, et al. Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomized phase III trial. Lancet Oncol. 2007;8:881–8.CrossRefPubMed Krag DN, Anderson SJ, Julian TB, Brown AM, Harlow SP, Ashikaga T, et al. Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomized phase III trial. Lancet Oncol. 2007;8:881–8.CrossRefPubMed
9.
go back to reference Dale PS, Williams JT IV. Axillary staging utilizing selective sentinel lymphadenectomy for patients with invasive breast carcinoma. Am Surg. 1998;64:28–31.PubMed Dale PS, Williams JT IV. Axillary staging utilizing selective sentinel lymphadenectomy for patients with invasive breast carcinoma. Am Surg. 1998;64:28–31.PubMed
10.
go back to reference Guenther JM, Krishnamoorthy M, Tan LR. Sentinel lymphadenectomy for breast cancer in a community managed care setting. Cancer J Sci Am. 1997;3:336–40.PubMed Guenther JM, Krishnamoorthy M, Tan LR. Sentinel lymphadenectomy for breast cancer in a community managed care setting. Cancer J Sci Am. 1997;3:336–40.PubMed
11.
go back to reference Grube BJ, Giuliano AE. Observation of the breast cancer patient with a tumor-positive sentinel node: implications of the ACOSOG Z0011 trial. Semin Surg Oncol. 2001;20:230–7.CrossRefPubMed Grube BJ, Giuliano AE. Observation of the breast cancer patient with a tumor-positive sentinel node: implications of the ACOSOG Z0011 trial. Semin Surg Oncol. 2001;20:230–7.CrossRefPubMed
12.
go back to reference Miner TJ, Shriver CD, Flicek PR, Miner FC, Jaques DP, Maniscalco-Theberge ME, et al. Guidelines for the safe use of radioactive materials during localization and resection of the sentinel lymph node. Ann Surg Oncol. 1999;6:75–82.CrossRefPubMed Miner TJ, Shriver CD, Flicek PR, Miner FC, Jaques DP, Maniscalco-Theberge ME, et al. Guidelines for the safe use of radioactive materials during localization and resection of the sentinel lymph node. Ann Surg Oncol. 1999;6:75–82.CrossRefPubMed
13.
go back to reference Omoto K, Hozumi Y, Omoto Y, Taniguchi N, Itoh K, Fujii Y, et al. Sentinel node detection in breast cancer using contrast-enhanced sonography with 25% albumin—initial clinical experience. J Clin Ultrasound. 2006;34:317–26.CrossRefPubMed Omoto K, Hozumi Y, Omoto Y, Taniguchi N, Itoh K, Fujii Y, et al. Sentinel node detection in breast cancer using contrast-enhanced sonography with 25% albumin—initial clinical experience. J Clin Ultrasound. 2006;34:317–26.CrossRefPubMed
14.
go back to reference Kitai T, Inomoto T, Miwa M, Shikayama T. Fluorescence navigation with indocyanine green for detecting sentinel lymph nodes in breast cancer. Breast Cancer. 2005;12:211–5.CrossRefPubMed Kitai T, Inomoto T, Miwa M, Shikayama T. Fluorescence navigation with indocyanine green for detecting sentinel lymph nodes in breast cancer. Breast Cancer. 2005;12:211–5.CrossRefPubMed
15.
go back to reference Weissleder R, Elizondo G, Wittenberg J, Lee AS, Josephson L, Brady TJ. Ultrasmall superparamagnetic iron oxide: an intravenous contrast agent for assessing lymph nodes with MR imaging. Radiology. 1990;175:494–8.PubMed Weissleder R, Elizondo G, Wittenberg J, Lee AS, Josephson L, Brady TJ. Ultrasmall superparamagnetic iron oxide: an intravenous contrast agent for assessing lymph nodes with MR imaging. Radiology. 1990;175:494–8.PubMed
16.
go back to reference Weissleder R, Elizondo G, Wittenberg J, Rabito CA, Bengele HH, Josephson L. Ultrasmall superparamagnetic iron oxide: characterization of a new class of contrast agents for MR imaging. Radiology. 1990;175:489–93.PubMed Weissleder R, Elizondo G, Wittenberg J, Rabito CA, Bengele HH, Josephson L. Ultrasmall superparamagnetic iron oxide: characterization of a new class of contrast agents for MR imaging. Radiology. 1990;175:489–93.PubMed
17.
go back to reference Michel SC, Keller TM, Frohlich JM, Fink D, Caduff R, Seifert B, et al. Preoperative breast cancer staging: MR imaging of the axilla with ultrasmall superparamagnetic iron oxide enhancement. Radiology. 2002;225:527–36.CrossRefPubMed Michel SC, Keller TM, Frohlich JM, Fink D, Caduff R, Seifert B, et al. Preoperative breast cancer staging: MR imaging of the axilla with ultrasmall superparamagnetic iron oxide enhancement. Radiology. 2002;225:527–36.CrossRefPubMed
18.
go back to reference Ferrucci JT, Stark DD. Iron oxide-enhanced MR imaging of the liver and spleen: review of the first 5 years. AJR Am J Roentgenol. 1990;155:943–50.CrossRefPubMed Ferrucci JT, Stark DD. Iron oxide-enhanced MR imaging of the liver and spleen: review of the first 5 years. AJR Am J Roentgenol. 1990;155:943–50.CrossRefPubMed
19.
go back to reference Nakagawa T, Minamiya Y, Katayose Y, Saito H, Taguchi K, Imano H, et al. A novel method for sentinel lymph node mapping using magnetite in patients with non-small cell lung cancer. J Thorac Cardiovasc Surg. 2003;126:563–7.CrossRefPubMed Nakagawa T, Minamiya Y, Katayose Y, Saito H, Taguchi K, Imano H, et al. A novel method for sentinel lymph node mapping using magnetite in patients with non-small cell lung cancer. J Thorac Cardiovasc Surg. 2003;126:563–7.CrossRefPubMed
20.
go back to reference Minamiya Y, Ito M, Katayose Y, Saito H, Imai K, Sato Y, et al. Intraoperative sentinel lymph node mapping using a new sterilizable magnetometer in patients with nonsmall cell lung cancer. Ann Thorac Surg. 2006;81:327–30.CrossRefPubMed Minamiya Y, Ito M, Katayose Y, Saito H, Imai K, Sato Y, et al. Intraoperative sentinel lymph node mapping using a new sterilizable magnetometer in patients with nonsmall cell lung cancer. Ann Thorac Surg. 2006;81:327–30.CrossRefPubMed
21.
go back to reference Ishiyama K, Sashi R, Katayose Y, Tomura N, Watarai J, Narita K. Sentinel lymph node after intramammary injection of superparamagnetic iron oxide (article in Japanese). Nippon Igaku Hoshasen Gakkai Zasshi. 2002;62:744–6.PubMed Ishiyama K, Sashi R, Katayose Y, Tomura N, Watarai J, Narita K. Sentinel lymph node after intramammary injection of superparamagnetic iron oxide (article in Japanese). Nippon Igaku Hoshasen Gakkai Zasshi. 2002;62:744–6.PubMed
Metadata
Title
Sentinel lymph node biopsy in patients with breast cancer using superparamagnetic iron oxide and a magnetometer
Authors
Mikio Shiozawa
Alan T. Lefor
Yasuo Hozumi
Katsumi Kurihara
Naohiro Sata
Yoshikazu Yasuda
Moriaki Kusakabe
Publication date
01-07-2013
Publisher
Springer Japan
Published in
Breast Cancer / Issue 3/2013
Print ISSN: 1340-6868
Electronic ISSN: 1880-4233
DOI
https://doi.org/10.1007/s12282-011-0327-9

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