SPIO (Magtrace®)-guided Sentinel Lymph Node Biopsy (SLNB) in early breast cancer - first monoinstitutional data and perspectives
Aim Super-paramagnetic iron oxide particle (SPIO)-techniques are reasonable alternatives to Tc99m-localization of SLNB with a similar detection rate but benefits regarding surgeon-guided and time-consuming operations. Concerns regarding staining and postoperative MRI were former reported. AGO-guidelines recommend SPIO-techniques as +/-. SLNB with 2 ml Magtrace® was implemented into clinical routine at our site.
Material Magtrace® was injected peritumoral (BCS) or periareolar (M/NSM) in about 15 mm depth under the skin pre-operatively (OR-setting) followed by a 5 min massage from the injection site towards the axilla and additional 20 min waiting time. A first measurement for confirmation of a sufficient transcutaneous signal was done immediately before incision.
Methods A retrospective documentation was done from 5-10/19 in 50 patients with breast conserving surgery (BCS), mastectomy (M) or nipple-sparing mastectomy (NSM). 24 % were treated pre-operatively with primary systemic chemotherapy.
Results Age of the patients was between 33 - 83 years. SLN-detection rate was 94.0 %. Operation time (only SLNB) ranges from 3 to 28 min (median: 8 min). Staining is not reported using injection techniques not direct subcutaneously.
Conclusion SPIO-guided SLNB was easy to handle and sufficient independent on PST and targeted axillary dissection. With an increasing number of procedures and prospective clinical trials including the 1ml-injection dosage SPIO-guided SLNB will be established as an alternative to ICG-/Technetium-based procedures and implemented in the AXSANA-Registry of the EUBREAST. An ongoing trial (Charité; Berlin) will focus on efficacy in direct comparison to Tc99m-based procedures.
Detailed results including after care imaging reports will be presented.
24 June 2020 (online)
© Georg Thieme Verlag KG
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