Bow to your SenSzi.
Top Line: The technique for sentinel lymph node (SLN) biopsy for breast cancer typically includes injection of both a radioactive tracer and a dye.
The Study: While the radioactive tracer is detected intra-operatively with a hand-held probe, some surgeons also use preoperative lymphoscintigraphy (LSG) to get a heads up of where they should be looking. The scan takes time (often upwards of an extra hour) and resources, though, with unclear benefit in the accuracy of the overall process. For now, The American Society of Breast Surgeons leaves it up to the surgeon. In the SenSzi trial, women with early-stage, clinically node-negative breast cancer undergoing SLN biopsy with pre-op LSG were randomized to surgery with or without knowledge of the LSG results. The study was designed to determine if SLN biopsy minus the LSG was non-inferior at detecting SLNs. Nearly 1200 German and Swiss women were enrolled, and the mean number of SLNs excised without LSG (2.3) was non-inferior to those excised with LSG (2.2). There were also no difference in the rates of involved SLNs nor rates of completion axillary dissection.
Bottom Line: Performing breast sentinel lymph node biopsy without lymphoscintigraphy finds just as many SLNs with less time and hassle. | Kuemmel, J Clin Oncol 2019
The Study: While the radioactive tracer is detected intra-operatively with a hand-held probe, some surgeons also use preoperative lymphoscintigraphy (LSG) to get a heads up of where they should be looking. The scan takes time (often upwards of an extra hour) and resources, though, with unclear benefit in the accuracy of the overall process. For now, The American Society of Breast Surgeons leaves it up to the surgeon. In the SenSzi trial, women with early-stage, clinically node-negative breast cancer undergoing SLN biopsy with pre-op LSG were randomized to surgery with or without knowledge of the LSG results. The study was designed to determine if SLN biopsy minus the LSG was non-inferior at detecting SLNs. Nearly 1200 German and Swiss women were enrolled, and the mean number of SLNs excised without LSG (2.3) was non-inferior to those excised with LSG (2.2). There were also no difference in the rates of involved SLNs nor rates of completion axillary dissection.
Bottom Line: Performing breast sentinel lymph node biopsy without lymphoscintigraphy finds just as many SLNs with less time and hassle. | Kuemmel, J Clin Oncol 2019
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