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Superparamagnetic iron oxide (SPIO) for axillary mapping in patients with ductal carcinoma in situ undergoing mastectomy: single-institution experience

  • Epidemiology
  • Published:
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Abstract

Purpose

Unnecessary axillary surgery can potentially be avoided in patients with DCIS undergoing mastectomy. Current guidelines recommend upfront sentinel lymph node biopsy during the index operation due to the potential of upstaging to invasive cancer. This study reviews a single institution’s experience with de-escalating axillary surgery using superparamagnetic iron oxide dye for axillary mapping in patients undergoing mastectomy for DCIS.

Methods

This is a retrospective single-institution cross-sectional study. All medical records of patients who underwent mastectomy for a diagnosis of DCIS from August 2021 to January 2023 were reviewed and patients who had SPIO injected at the time of the index mastectomy were included in the study. Descriptive statistics of demographics, clinical information, pathology results, and interval sentinel lymph node biopsy were performed.

Results

A total of 41 participants underwent 45 mastectomies for DCIS. The median age of the participants was 58 years (IQR = 17; range 25 to 76 years), and the majority of participants were female (97.8%). The most common indication for mastectomy was diffuse extent of disease (31.7%). On final pathology, 75.6% (34/45) of mastectomy specimens had DCIS without any type of invasion and 15.6% (7/45) had invasive cancer. Of the 7 cases with upgrade to invasive disease, 2 (28.6%) of them underwent interval sentinel lymph node biopsy. All sentinel lymph nodes biopsied were negative for cancer.

Conclusion

The use of superparamagnetic iron oxide dye can prevent unnecessary axillary surgery in patients with DCIS undergoing mastectomy.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available because of institutional privacy regulations but are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Surgical Oncology and Endocrine Surgery, Vanderbilt University Medical Center, Preston Research Building, 2220 Pierce Ave., Nashville, TN, 37232, USA

    Jamin Kweku Addae, Raeshell Sharawn Sweeting, Ingrid Marie Meszoely, Rachel Louise McCaffrey, Rondi Marie Kauffmann, Mark Carlton Kelley, Ana Magdalena Grau & Kelly Hewitt

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  1. Jamin Kweku Addae
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  2. Raeshell Sharawn Sweeting
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  3. Ingrid Marie Meszoely
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  4. Rachel Louise McCaffrey
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  5. Rondi Marie Kauffmann
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  6. Mark Carlton Kelley
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  7. Ana Magdalena Grau
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  8. Kelly Hewitt
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Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by JKA and KH. The first draft of the manuscript was written by JKA and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Jamin Kweku Addae.

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Addae, J.K., Sweeting, R.S., Meszoely, I.M. et al. Superparamagnetic iron oxide (SPIO) for axillary mapping in patients with ductal carcinoma in situ undergoing mastectomy: single-institution experience. Breast Cancer Res Treat 204, 117–121 (2024). https://doi.org/10.1007/s10549-023-07193-7

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