Own Experience of using the Radiopharmaceutical 99mTc-sentiskan in Visualization of Sentinel Lymph Nodes in Patients with Breast Cancer

Abstract

Purpose: To study the capabilities of the new radiopharmaceutical 99mTc-sentiscan in the visualization of sentinel lymph nodes in patients with breast cancer. Material and methods: A survey of 178 people diagnosed with breast cancer. Patients were divided into two groups depending on the route of administration of the radiopharmaceutical. The day before surgical treatment, all subjects were injected with a radiopharmaceutical using a syringe with an activity of no more than 120 MBq, in a volume of 0.3‒0.4 ml. The visualized sentinel lymph nodes were marked on the skin using a patented device – «Device for external marking of sentinel lymph nodes during radionuclide visualization». Intraoperative search for sentinel lymph nodes was carried out using gamma detectors Gamma-Finder II or Radical, followed by urgent histological examination. Results: Radioisotope visualization of sentinel lymph nodes using the domestic radiopharmaceutical 99mTc-sentiscan: in the first group (the drug was administered peritumorally) was 100 %, the average number of visualized lymph nodes in this group was 2.2; in the second group (the drug was administered subareolarly) ‒ 99.1 %, the average number of visualized lymph nodes ‒ 2.6. In the first group of patients, metastatic lesions of sentinel lymph nodes were detected in 8 cases (13.1 %), and in the second group ‒ in 14 (11.9 %). All lymph nodes were mapped in the axillary region on the side of the tumor process. Conclusion: The possibility of the radiopharmaceutical 99mTc-sentiscan for the identification and biopsy of sentinel lymph nodes in patients with breast cancer was assessed. The use of the domestic 99mTc-sentiscan makes it possible to visualize sentinel lymph nodes in patients with breast cancer and detect their location in 99.1‒100 % of cases. Taking into account the results obtained, the expanded indications for the use of the radiopharmaceutical and the cost of the kits, 99mTc-sentiscan is more preferable for use in clinical practice.