Sentinel lymph node biopsy with a novel sentinel lymphoscintigraphy agent ~(99m)Tc-Rituximab for breast cancer

Objective To study the feasibility and reliability of the sentinel lymph node(SLN)imaging and biopsy with a new imaging agent 99mTc-Rituximab in 102 breast cancer patients(one suffered bilateral breast cancers).Methods The sentinel lymph node imaging was taken after peritumoral and subdermal injection of 99mTc-Rituximab guided with ultrasound,and was fused with each digital photo.After the sentinel lymph node biopsy(SLNB),routine surgery of breast and axillary lymph node dissection(ALND)was performed.Fresh SLNs and all axillary nodes were examined by pathology.Results There were total 103 times SLN imaging and SLNB in 102 patients,and the success rate of the SLN imaging was 100%.Total 177 SLNs(the average was 1.72)were showed in the images,which distributed in the axilla,the internal mammary and the breast region.The success rate of SLNB was 99.03%,and total 266 SLNs(the average was 2.58)were identified.Pathological examination showed that there were 76 times of metastatic SLN and the total number of metastatic SLN were 110.The sensitivity,specificity and accuracy of SLNB were 96.20%,100% and 97.09%,respectively;and the false negative rate of SLNB was 3.80%.Conclusion Using 99mTc-Rituximab as the imaging agent,the sentinel lymph node imaging and biopsy can obtain high success rate,high sensitivity and accuracy,and low false negative rate,so this novel sentinel lymphoscintigraphy agent will have a good future in clinical practice.