Sentinel node biopsy in 70 unselected patients with breast cancer: increased feasibility by using 10 mCi radiocolloid in combination with a blue dye tracer

Aims: Lymphatic mapping and sentinel node (SN) biopsy in breast cancer cont ribute to more accurate staging, while using less invasive techniques. The aim of this study is to improve the accuracy and feasibility of this concep t, increasing the identification rate of the SN, by using an alternative te chnique. Methods: In 70 unselected patients with primary breast cancer, of whom 51% had undergone previous excisional biopsy, lymphatic mapping was performed u sing 10 mCi (370 MBq) Tc-99m-nanocolloid peritumorally, combined with an in tradermal blue dye tracer. Results: Lymphoscintigraphy showed one or more SN in 97% and harvest of the SN was possible in all patients (identification rate 100%). Axillary metas tases were found in 39%. Sensitivity of the SN biopsy was high, both after primary surgery (93%) and after previous surgery (100%). Internal mammary l ymph node biopsy following lymphatic mapping was attempted in all 24 patien ts (34%) with parasternal SN visible on the scan and was successful in 15 p atients, revealing metastatic involvement in five patients. Conclusions: We conclude that SN biopsy, using a higher dose of peritumoral radiocolloid tracer, combined with intradermal blue dye tracer, increases feasibility in breast cancer, making this concept applicable for all patien ts with primary breast cancer.