Sentinel node biopsy with technetium-99m colloidal rhenium sulphide in patients with breast cancer

Background: Sentinel node biopsy is emerging as a technique to replace rout ine axillary lymph node dissection. The lymphatic mapping technique is stil l at a developmental stage and no standard technique exists. This study use d technetium-99m colloidal rhenium sulphide with a mean particle size of 10 0 (range 50-200) nm for sentinel node mapping. Methods: Eighty-seven patients with breast cancer, but no clinical evidence of axillary metastasis, were studied. One day before operation technetium- 99m colloidal rhenium sulphide was injected at four points into breast tiss ue surrounding the tumour. Lymphoscintigraphy was performed 2 h after injec tion, and surgery was usually performed after 20 h. A hand-held gamma probe guided sentinel node biopsy. Results: Lymphoscintigraphy revealed axillary hot spots in all patients. Du ring operation, the sentinel node was identified in all 87 patients (100 pe r cent). The number of sentinel nodes per patient ranged from 1 to 5 (mean 2). Metastatic sentinel nodes were identified in 37 of 87 patients. There w ere no false negatives. Conclusion: This study suggests that technetium-99m rhenium sulphide is a s uitable agent for sentinel node mapping in patients with breast cancer.