TC-99M-LABELED SM3 IN THE PREOPERATIVE EVALUATION OF AXILLARY LYMPH-NODES AND PRIMARY BREAST-CANCER WITH CHANGE DETECTION STATISTICAL PROCESSING AS AN AID TO TUMOR-DETECTION

The extent of primary surgery for breast cancer could be tailored to t he patient if previous information on the presence or absence of lymph node involvement could be reliably determined. Prospective radioimmun oscintigraphy in 29 patients with primary breast cancer that was found on screening has been undertaken with 555 MBq (15 mCi) Tc-99m SM3, an Imperial Cancer Research Fund (ICRF) murine monoclonal antibody, 0.5 mg with images at 10 min and 22 h, and analysis using a change detecti on algorithm. Sites of significant change between the early and later images were displayed as a map of probabilities. Image-positive and -n egative axillary lymph nodes were compared by histology in the 28 eval uable patients. The correct identification of the presence or absence of node involvement, even if impalpable, has been shown in 24 out of 2 8 patients (29 lymph node groups). Sensitivity was 90% (nine out of te n), specificity 84% (16 out of 19) and accuracy 86%. These results enc ourage further assessment of this technique.