Sentinel node detection in breast cancer by high resolution portable camera

Introduction: Sentinel node (SN) biopsy isa widely used method for breast cancer staging by surgeons of several institutions. Lymphoscintigrafy (LS) is generally preferred but some surgeons suggest the use both radioactive colloids and blue vital dye Removal ofsentinel node with radio-guided surgery isalso arather easy and fast method. Some problems can probably be overcome by using a portable imaging device in the operation theatre High resolution (HR), small field of view (FOV) gamma cameras have been the object of our studies since early nineties, just after Hamamatsu developed the first position sensitive photomultiplier tube (PSPMT). The aim of the present study is to demonstrate that surgery removes the mammary SN quicker and with greater precision when using IP and con- ventional probe together, as opposed to conventional probe only. Patients and methods: We enrolled 100 consecutive patients (average age 50,3 ± 9) with T1 breast cancer and clinically negative nodes who had been scheduled for conservative surgery with SN biopsy. These patients were divided into 2 groups of 50 patients: group A in which the SN was detected only with a conventional probe (Neoprobe 2000, Ethicon US(, group B in which detection of SN was carried out with both conventional probe and IP. Though the patients were consecutive, the two groups were age matched and the percentage of obese patients was similar in the two groups: Sentinel node detection and biopsy: After induction of general anaesthesia in the operation room, in group Athe gamma-detecting probe protected by a sterile glove was passed over the axilla's starting from the skin mark drawn with LS, in order to locate SN. A small transverse axillary's incision was then made, and hot nodes were isolated under the guidance of the probe. Each radioactive lymph node was removed. In group B the IP was passed over the axilla's to locate SN. IP detection also started from the skin marks, however dependence on marks was less strict, because2 to 4 positions of IP are able to scan the entire field. High resolution camera: Present series was carried out with the one inch2 IP 824 (Li-Tech, Italy) which is an improved version of other IP we have already used. Results are sumarized in table 1