Cysteine rhenium colloid: a novel radiocolloid for identifying sentinel lymph nodes in breast cancer surgery

Clin Breast Cancer. 2015 Feb;15(1):e41-5. doi: 10.1016/j.clbc.2014.07.006. Epub 2014 Aug 15.

Abstract

Background: Medical isotopes are required for sentinel node lymphoscintigraphy in breast cancer, but are in critical shortage. Our center uses a modification of the standard SC, called CRC, that has been shown to require less medical isotope for the same procedure. Our objective was to determine if there was a significant difference between SC and CRC in successful lymph node identification in breast cancer patients.

Patients and methods: This was a retrospective cohort study using prospectively-collected data on 1205 consecutive early, clinically node-negative breast cancer patients who underwent a SNB between 2002 and 2008 at 2 tertiary hospitals in Canada.

Results: There was no difference in successful lymph node identification rate (P = .50) or in the mean number of positive nodes identified between the 2 colloids (P = .88). The CRC group had a significantly lower rate of delayed adverse events (4.91% vs. 0.59%, P < .0001) even after adjusting for whether axillary dissection occurred on the same day as the biopsy (adjusted odds ratio, 0.12; 95% confidence interval, 0.04-0.40; P = .001).

Conclusion: Our findings suggest that there is no significant difference between CRC and SC in detecting sentinel nodes; however, CRC uses less medical isotopes. In the current climate of critical shortages of medical radioisotopes, radiocolloids should be selected for use based on amount of radioisotope required.

Keywords: Clinical trial; Lymphoscintigraphy; Nuclear medicine; Sentinel node biopsy; Sulfur colloid.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery*
  • Colloids
  • Cysteine
  • Female
  • Humans
  • Intraoperative Period
  • Lymphatic Metastasis
  • Mastectomy
  • Middle Aged
  • Radioisotopes*
  • Radionuclide Imaging
  • Radiopharmaceuticals*
  • Retrospective Studies
  • Rhenium*
  • Sentinel Lymph Node Biopsy / methods*

Substances

  • Colloids
  • Radioisotopes
  • Radiopharmaceuticals
  • Rhenium
  • Cysteine