Radioguidance for nonpalpable primary lesions and sentinel lymph node(s)

Background: Radioguided surgery can also be used for the simultaneous guida nce to a nonpalpable primary tumor and sentinel lymph nodes. Methods: Retrospective review of a prospective database. The surgeon used a gamma probe for guidance to an iodine-125 labeled titanium seed at the pri mary lesion and technetium-99 labeled sulfur colloid at the sentinel lymph node. Results: Forty-three patients with nonpalpable breast carcinoma underwent d ual isotope radioguided surgery. The radioactive seed and primary lesion we re retrieved in the first excision in all 44 patients (100%). Eleven patien ts (25%) had pathologically involved margins. Sentinel lymph node mapping w as successful in 42 patients (98%). A mean of 2.4 sentinel nodes were excis ed and metastatic carcinoma was present in four patients (10%). Conclusions: Dual isotopes can be effectively used in breast cancer patient s for simultaneous radioguidance to both a nonpalpable primary lesion and s entinel lymph node and allows for improved logistics. (C) 2001 Excerpta Med ica, Inc. All rights reserved.