Radiation protection in radioguided surgery of breast cancer

The protocols for sentinel lymph node biopsy and radioguided occult lesion localization could potentially be of great value in the management of breas t cancer patients. Both involve the injection of a Tc-99(m)-labelled radiop harmaceutical close to or into the lesion, localization of the sentinel lym ph node or occult lesion by scintigraphy, and surgical removal with the aid of a hand-held gamma-ray detector. We present dosimetric data on patients and hospital personnel involved in these procedures. For evaluation of radi ation protection, we measured the absorbed dose and air kerma rate. Activit y levels in excised tissues and surgical instruments were also determined. For patients, the mean absorbed dose to the abdomen was 0.45 mGy, which is low compared to doses received from other diagnostic examinations. For surg eons after 100 operations, the mean absorbed dose to the hands was 0.45 mGy and the mean effective dose 0.09 mSv. Absorbed doses to all hospital perso nnel involved in the procedures were very low compared to recommended annua l limits stipulated by the international Commission on Radiological Protect ion. We conclude that these procedures, performed according to protocols la id down by the European Institute of Oncology, Milan, are safe from the poi nt of view of radiological protection and that only routine precautions are necessary. ((C) 1999 Lippincott Williams & Wilkins).