pISSN 1738-6756   eISSN 2092-9900
Open Access, Peer-reviewed
    J Breast Cancer. 2006 Jun;9(2):121-126. Korean.
    Published online Jun 30, 2006.
    https://doi.org/10.4048/jbc.2006.9.2.121
    Copyright © 2006 Korean Breast Cancer Society
    Original Article

    Utility of Breast Sentinel Lymph Node Biopsy Using the Day-Before or the Same-Day Subareolar Injection of 99mTc-Tin Colloid

    Kang Seok Kim, Yang Hee Kim, Nam Sun Paik, Min Suk Kim,1 Chang Woon Choi,2 Nan Mo Moon and Woo Chu Noh
      • Department of Surgery, Korea Cancer Center Hospital, Seoul, Korea.
      • 1Department of Pathology, Korea Cancer Center Hospital, Seoul, Korea.
      • 2Department of Nuclear Medicine, Korea Cancer Center Hospital, Seoul, Korea.
    • Corresponding author (Email: nohwoo@kcch.re.kr )
    Received February 23, 2006; Accepted April 07, 2006.

    Abstract

    Purpose

    The aims of this study were to examine the feasibility of sentinel lymph node (SLN) biopsy using the day-before-surgery or the same-day subareolar injection of 99mTc-Tin colloid, and to evaluate the accuracy of performing intraoperative multiple frozen section diagnosis of the SLN for breast cancer.

    Methods

    From Jul. 2003 to Feb. 2004, a total of 81 women with clinically node negative breast cancer underwent SLN biopsy and this was followed by axillary lymph node dissection at the Korea Cancer Center Hospital. 2~2.5mCi of 99mTc-Tin colloid was injected intradermally in the outer upper edge of the areola on the day before or the same day of surgery, and lymphoscintigraphy was then obtained. The time interval between the injection of tracer and SLN biopsy varied from 1 hour to 20 hours. Intraoperatively, the status of the SLNs was examined by multiple frozen section diagnosis and all the SLNs were subjected to serial sectioning for Hematoxylin-eosin staining and immunohistochemical staining for cytokeratin. After removal of the SLNs, standard level I and II axillary dissection was performed in all patients.

    Results

    In 26 patients (32.1%), the SLNs were positive for tumor cells among these 26 patients. 16 patients (61.5%) results showed that the SLNs were the only metastatic nodes. Two cases of false negative findings were identified. The sensitivity and specificity were 92.9% and 100% respectively. In the second half of this study, no false-negative cases were found in 41 consecutive patients.

    Conclusion

    The results of SLN biopsy using the day-before-surgery or same-day subareolar injection of 99mTc-Tin colloid were excellent for identification of the SLNs. This technique does not interfere with effective treatment in the operating room because the time interval between the injection and surgery did not affect the results of SLN biopsy. Intraoperative multiple frozen section diagnosis of SLNs was readily available, and this was highly accurate for assessing the status of SLNs.

    Keywords
    Breast neoplasm; Frozen section; Sentinel lymph node; Technetium Tc99mTin colloid

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    MeSH Terms
    Biopsy
    Breast Neoplasms
    Breast*
    Colloids*
    Diagnosis
    Female
    Frozen Sections
    Humans
    Keratins
    Korea
    Lymph Node Excision
    Lymph Nodes
    Lymphoscintigraphy
    Operating Rooms
    Sensitivity and Specificity
    Sentinel Lymph Node Biopsy*
    Metrics
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