Comparison of axillary node sampling and sentinel lymph node biopsy before and after the introduction of Sentimag® magnetic tracer technology
Association of Breast Surgery ePoster Library. Mirshekar-Syahkal B. 05/13/19; 257058; P014
Bahar Mirshekar-Syahkal
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P014
Topic: Axilla
IntroductionSentinel lymph node biopsy (SLNB) is the accepted standard for assessing the axilla in breast cancer patients with clinically node-negative disease. In the absence of a dual technique to identify sentinel nodes, four-node axillary sampling (ANS) should be performed, however increased nodal excision is associated with increased morbidity. In April 2017 our unit changed its practice from blue dye-assisted ANS to SLNB using blue dye and Sentimag®. The aim of this study was to evaluate the effects of this change following completion of a six month learning period. Methods A service evaluation project was registered with our Trust to perform a retrospective case notes analysis of all breast cancer patients undergoing axillary staging surgery for one year pre-Sentimag® (01/04/2016 to 31/03/2017) and post-Sentimag® (01/10/2017 to 30/09/2018). Results: 347 axillary staging procedures were performed in total (Table 1). The commonest reasons for not using Sentimag® were previous surgery (13/161 patients) and poor renal function (6/161 patients). 7/134 (5%) SLNB procedures failed (no tracer detected). Significantly fewer lymph nodes were removed using SLNB than ANS (median 2 vs 3; Mann Whitney p<0.0001); there was no significant difference in the number of axillary node clearances (15/134 vs 21/213; Fisher's exact test p=0.72). Conclusions: SLNB using blue dye and Sentimag® instead of ANS is appropriate for the majority of patients requiring axillary staging and may reduce axillary morbidity by reducing the number of lymph nodes removed. Sentimag® provides an excellent non-radioactive alternative for SLNB.
Topic: Axilla
IntroductionSentinel lymph node biopsy (SLNB) is the accepted standard for assessing the axilla in breast cancer patients with clinically node-negative disease. In the absence of a dual technique to identify sentinel nodes, four-node axillary sampling (ANS) should be performed, however increased nodal excision is associated with increased morbidity. In April 2017 our unit changed its practice from blue dye-assisted ANS to SLNB using blue dye and Sentimag®. The aim of this study was to evaluate the effects of this change following completion of a six month learning period. Methods A service evaluation project was registered with our Trust to perform a retrospective case notes analysis of all breast cancer patients undergoing axillary staging surgery for one year pre-Sentimag® (01/04/2016 to 31/03/2017) and post-Sentimag® (01/10/2017 to 30/09/2018). Results: 347 axillary staging procedures were performed in total (Table 1). The commonest reasons for not using Sentimag® were previous surgery (13/161 patients) and poor renal function (6/161 patients). 7/134 (5%) SLNB procedures failed (no tracer detected). Significantly fewer lymph nodes were removed using SLNB than ANS (median 2 vs 3; Mann Whitney p<0.0001); there was no significant difference in the number of axillary node clearances (15/134 vs 21/213; Fisher's exact test p=0.72). Conclusions: SLNB using blue dye and Sentimag® instead of ANS is appropriate for the majority of patients requiring axillary staging and may reduce axillary morbidity by reducing the number of lymph nodes removed. Sentimag® provides an excellent non-radioactive alternative for SLNB.
P014
Topic: Axilla
IntroductionSentinel lymph node biopsy (SLNB) is the accepted standard for assessing the axilla in breast cancer patients with clinically node-negative disease. In the absence of a dual technique to identify sentinel nodes, four-node axillary sampling (ANS) should be performed, however increased nodal excision is associated with increased morbidity. In April 2017 our unit changed its practice from blue dye-assisted ANS to SLNB using blue dye and Sentimag®. The aim of this study was to evaluate the effects of this change following completion of a six month learning period. Methods A service evaluation project was registered with our Trust to perform a retrospective case notes analysis of all breast cancer patients undergoing axillary staging surgery for one year pre-Sentimag® (01/04/2016 to 31/03/2017) and post-Sentimag® (01/10/2017 to 30/09/2018). Results: 347 axillary staging procedures were performed in total (Table 1). The commonest reasons for not using Sentimag® were previous surgery (13/161 patients) and poor renal function (6/161 patients). 7/134 (5%) SLNB procedures failed (no tracer detected). Significantly fewer lymph nodes were removed using SLNB than ANS (median 2 vs 3; Mann Whitney p<0.0001); there was no significant difference in the number of axillary node clearances (15/134 vs 21/213; Fisher's exact test p=0.72). Conclusions: SLNB using blue dye and Sentimag® instead of ANS is appropriate for the majority of patients requiring axillary staging and may reduce axillary morbidity by reducing the number of lymph nodes removed. Sentimag® provides an excellent non-radioactive alternative for SLNB.
Topic: Axilla
IntroductionSentinel lymph node biopsy (SLNB) is the accepted standard for assessing the axilla in breast cancer patients with clinically node-negative disease. In the absence of a dual technique to identify sentinel nodes, four-node axillary sampling (ANS) should be performed, however increased nodal excision is associated with increased morbidity. In April 2017 our unit changed its practice from blue dye-assisted ANS to SLNB using blue dye and Sentimag®. The aim of this study was to evaluate the effects of this change following completion of a six month learning period. Methods A service evaluation project was registered with our Trust to perform a retrospective case notes analysis of all breast cancer patients undergoing axillary staging surgery for one year pre-Sentimag® (01/04/2016 to 31/03/2017) and post-Sentimag® (01/10/2017 to 30/09/2018). Results: 347 axillary staging procedures were performed in total (Table 1). The commonest reasons for not using Sentimag® were previous surgery (13/161 patients) and poor renal function (6/161 patients). 7/134 (5%) SLNB procedures failed (no tracer detected). Significantly fewer lymph nodes were removed using SLNB than ANS (median 2 vs 3; Mann Whitney p<0.0001); there was no significant difference in the number of axillary node clearances (15/134 vs 21/213; Fisher's exact test p=0.72). Conclusions: SLNB using blue dye and Sentimag® instead of ANS is appropriate for the majority of patients requiring axillary staging and may reduce axillary morbidity by reducing the number of lymph nodes removed. Sentimag® provides an excellent non-radioactive alternative for SLNB.
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