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Bergkvist, Leif
Alternative names
Publications (10 of 84) Show all publications
Andersson, Y., Bergkvist, L., Frisell, J. & de Boniface, J. (2019). Do clinical trials truly mirror their target population?: An external validity analysis of national register versus trial data from the Swedish prospective SENOMIC trial on sentinel node micrometastases in breast cancer. Breast Cancer Research and Treatment, 177(2), 469-475
Open this publication in new window or tab >>Do clinical trials truly mirror their target population?: An external validity analysis of national register versus trial data from the Swedish prospective SENOMIC trial on sentinel node micrometastases in breast cancer
2019 (English)In: Breast Cancer Research and Treatment, ISSN 0167-6806, E-ISSN 1573-7217, Vol. 177, no 2, p. 469-475Article in journal (Refereed) Published
Abstract [en]

Purpose: Increasing evidence suggests that completion axillary lymph node dissection (ALND) may be omitted in breast cancer patients with limited axillary nodal metastases. However, the representativeness of trial participants for the original clinical practice population, and thus, the generalizability of published trials have been questioned. We propose the use of background data from national registers as a means to assess whether trial participants mirror their target population and to strengthen the generalizability and implementation of trial outcomes.

Methods: The Swedish prospective SENOMIC trial, omitting a completion ALND in breast cancer patients with sentinel lymph node micrometastases, reached full target accrual in 2017. To assess the generalizability of trial results for the target population, a comparative analysis of trial participants versus cases reported to the Swedish National Breast Cancer Register (NKBC) was performed.

Results: Comparing 548 trial participants and 1070 NKBC cases, there were no significant differences in age, tumor characteristics, breast surgery, or adjuvant treatment. Only the mean number of sentinel lymph nodes with micrometastasis per individual was lower in trial participants than in register cases (1.06 vs. 1.09, p=0.037).

Conclusions: Patients included in the SENOMIC trial are acceptably representative of the Swedish breast cancer target population. There were some minor divergences between trial participants and the NKBC population, but taking these into consideration, upcoming trial outcomes should be generalizable to breast cancer patients with micrometastases in their sentinel lymph node biopsy.

Place, publisher, year, edition, pages
SPRINGER, 2019
Keywords
Breast cancer, Sentinel node biopsy, Micrometastases, Axillary lymph node dissection, Cohort study, Register
National Category
Surgery Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-392124 (URN)10.1007/s10549-019-05328-3 (DOI)000477675700020 ()31236811 (PubMedID)
Available from: 2019-09-03 Created: 2019-09-03 Last updated: 2019-09-03Bibliographically approved
Karakatsanis, A., Hersi, A.-F., Pistiolis, L., Bagge, R. O., Lykoudis, P. M., Eriksson, S., . . . Stålberg, P. (2019). Effect of preoperative injection of superparamagnetic iron oxide particles on rates of sentinel lymph node dissection in women undergoing surgery for ductal carcinoma in situ (SentiNot study). British Journal of Surgery, 106(6), 720-728
Open this publication in new window or tab >>Effect of preoperative injection of superparamagnetic iron oxide particles on rates of sentinel lymph node dissection in women undergoing surgery for ductal carcinoma in situ (SentiNot study)
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2019 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 106, no 6, p. 720-728Article in journal (Refereed) Published
Abstract [en]

Background: One-fifth of patients with a preoperative diagnosis of ductal carcinoma in situ (DCIS) have invasive breast cancer (IBC) on definitive histology. Sentinel lymph node dissection (SLND) is performed in almost half of women having surgery for DCIS in Sweden. The aim of the present study was to try to minimize unnecessary SLND by injecting superparamagnetic iron oxide (SPIO) nanoparticles at the time of primary breast surgery, enabling SLND to be performed later, if IBC is found in the primary specimen.

Methods: Women with DCIS at high risk for the presence of invasion undergoing breast conservation, and patients with DCIS undergoing mastectomy were included. The primary outcome was whether this technique could reduce SLND. Secondary outcomes were number of SLNDs avoided, detection rate and procedure-related costs.

Results: This was a preplanned interim analysis of 189 procedures. IBC was found in 47 and a secondary SLND was performed in 41 women. Thus, 78.3 per cent of patients avoided SLND (P<0.001). At reoperation, SPIO plus blue dye outperformed isotope and blue dye in detection of the sentinel node (40 of 40 versus 26 of 40 women; P<0.001). Costs were reduced by a mean of 24.5 per cent in women without IBC (3990 versus 5286; P<0.001).

Conclusion: Marking the sentinel node with SPIO in women having surgery for DCIS was effective at avoiding unnecessary SLND in this study. Registration number: ISRCTN18430240 (http://www.isrctn.com).

Place, publisher, year, edition, pages
WILEY, 2019
National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-383156 (URN)10.1002/bjs.11110 (DOI)000465082200009 ()30839104 (PubMedID)
Funder
The Breast Cancer Foundation
Available from: 2019-05-10 Created: 2019-05-10 Last updated: 2019-05-10Bibliographically approved
Enlund, M., Enlund, A., Berglund, A. & Bergkvist, L. (2019). Rationale and Design of the CAN Study: An RCT of Survival after Propofol- or Sevoflurane-based Anesthesia for Cancer Surgery. Current pharmaceutical design, 25(28), 3028-3033
Open this publication in new window or tab >>Rationale and Design of the CAN Study: An RCT of Survival after Propofol- or Sevoflurane-based Anesthesia for Cancer Surgery
2019 (English)In: Current pharmaceutical design, ISSN 1381-6128, E-ISSN 1873-4286, Vol. 25, no 28, p. 3028-3033Article in journal (Refereed) Published
Abstract [en]

Background: Based on animal data only, some clinicians have adopted pmpofol-based anesthesia for cancer surgery with the aim of increased survival.

Objective: Our objective is to verify or refute the hypothesis that survival increases after cancer surgery with propofol compared with sevoflurane for anesthesia maintenance. This aim deserves a large-scale randomized study. The primary hypothesis is an absolute increase of minimum 5%-units in 1- and 5-year survival with propofol-based anesthesia for breast or colorectal cancer after radical surgery, compared with sevoflurane-based anesthesia.

Method: Ethics and medical agency approvals were received and pre-study registrations at clinicaltrial.gov and EudraCT were made for our now ongoing prospective, randomized, open-label, multicenter study. A power analysis based on a retrospective study, including a safety margin for drop outs, resulted in a total requirement of 8,000 patients. The initial inclusion period constituted a feasibility phase with an emphasis on the functionality of the infrastructure at the contributing centers and at the monitoring organization, as well as on protocol adherence.

Conclusion: The infrastructure and organization work smoothly at the different contributing centers. Protocol adherence is good, and the monitors are satisfied. We expect this trial to be able to either verify or refute that propofol is better than sevoflurane for cancer surgery.

Place, publisher, year, edition, pages
BENTHAM SCIENCE PUBL LTD, 2019
Keywords
Anesthetics/intravenous/inhalational, epidemiology, neoplasm recurrence, surgery, survival, inclusion period
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:uu:diva-396961 (URN)10.2174/1381612825666190705184218 (DOI)000491941600006 ()31298158 (PubMedID)
Funder
Swedish Research Council
Available from: 2019-11-13 Created: 2019-11-13 Last updated: 2019-11-13Bibliographically approved
Stilling, F., Wolk, A., Religa, D., Leppert, J., Bergkvist, L., Michaëlsson, K. & Larsson, S. C. (2018). Adipose tissue fatty acid composition and cognitive impairment. Nutrition (Burbank, Los Angeles County, Calif.), 54, 153-157
Open this publication in new window or tab >>Adipose tissue fatty acid composition and cognitive impairment
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2018 (English)In: Nutrition (Burbank, Los Angeles County, Calif.), ISSN 0899-9007, E-ISSN 1873-1244, Vol. 54, p. 153-157Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this study was to examine the association among adipose tissue eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arachidonic acid (AA), and the ratios of EPA to AA and DHA to AA with impaired cognitive function.

Methods: This cross-sectional analysis comprised 481 men participating in the Cohort of Swedish Men Clinical and for whom adipose tissue fatty acid composition and results from a telephone-based cognitive test were available. Impaired cognitive function was defined using a predefined cutoff on the cognitive test. Binomial log-linear regression models were used to estimate prevalence ratios. In secondary analyses, Cox proportional hazards models were used to estimate relative risk for incident dementia ascertained by linkage with population-based registers.

Results: We observed a graded reduction in the prevalence of impaired cognitive function across tertiles of adipose tissue EPA/AA- ratio (P-trend = 0.01); compared with the lowest tertile, the multivariable-adjusted prevalence ratios were, respectively, 0.89 (95% confidence interval [CI], 0.67-1.17) and 0.64 (95% CI, 0.45-0.91) for the second and third tertiles. EPA, DHA, and the DHA/AA ratio showed similar patterns of association; however, the CIs included the null. AA alone was not associated with impaired cognitive function. Although with lower precision, estimates obtained from the prospective analysis were broadly consistent with the main analysis.

Conclusions: Findings from this study suggest that a high ratio of EPA to AA in adipose tissue may be associated with better cognitive function. A similar association was observed with EPA, DHA, and the ratio of DHA to AA, but the results did not exclude a null association.

Keywords
Cognitive impairment, omega-3 Fatty acids, Biomarker, Adipose tissue, Aging
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:uu:diva-366941 (URN)10.1016/j.nut.2018.04.006 (DOI)000445322100022 ()29982142 (PubMedID)
Funder
EU, Horizon 2020, 633589Swedish Research Council, 2015-05997Swedish Research Council, 2012-2291
Available from: 2018-11-27 Created: 2018-11-27 Last updated: 2019-11-19Bibliographically approved
de Boniface, J., Frisell, J., Bergkvist, L. & Andersson, Y. (2018). Breast-conserving surgery followed by whole-breast irradiation offers survival benefits over mastectomy without irradiation. British Journal of Surgery, 105(12), 1607-1614
Open this publication in new window or tab >>Breast-conserving surgery followed by whole-breast irradiation offers survival benefits over mastectomy without irradiation
2018 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 105, no 12, p. 1607-1614Article in journal (Refereed) Published
Abstract [en]

Background: The prognostic equivalence between mastectomy and breast-conserving surgery (BCS) followed by radiotherapy was shown in pivotal trials conducted decades ago. Since then, detection and treatment of breast cancer have improved substantially and recent retrospective analyses point towards a survival benefit for less extensive breast surgery. Evidence for the association of such survival data with locoregional recurrence rates is largely lacking.

Methods: The Swedish Multicentre Cohort Study prospectively included clinically node-negative patients with breast cancer who had planned sentinel node biopsy between 2000 and 2004. Axillary lymph node dissection was undertaken only in patients with sentinel node metastases. For the present investigation, adjusted survival analyses were used to compare patients who underwent BCS and postoperative radiotherapy with those who received mastectomy without radiotherapy.

Results: Of 3518 patients in the Swedish Multicentre Cohort Study, 2767 were included in the present analysis; 2338 had BCS with postoperative radiotherapy and 429 had mastectomy without radiotherapy. Median follow-up was 156 months. BCS followed by whole-breast irradiation was superior to mastectomy without irradiation in terms of both overall survival (79.5 versus 64.3 per cent respectively at 13 years; P < 0.001) and breast cancer-specific survival (90.5 versus 84.0 per cent at 13 years; P < 0.001). The local recurrence rate did not differ between the two groups. The axillary recurrence-free survival rate at 13 years was significantly lower after mastectomy without irradiation (98.3 versus 96.2 per cent; P < 0.001).

Conclusion: The present data support the superiority or BCS with postoperative radiotherapy over mastectomy without radiotherapy. The axillary recurrence rate differed significantly, and could be one contributing factor in a complex explanatory model.

Place, publisher, year, edition, pages
WILEY, 2018
National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-369050 (URN)10.1002/bjs.10889 (DOI)000447124200008 ()29926900 (PubMedID)
Funder
Swedish Society for Medical Research (SSMF)The Breast Cancer FoundationSwedish Cancer Society
Available from: 2018-12-14 Created: 2018-12-14 Last updated: 2018-12-14Bibliographically approved
Andersson, Y., Bergkvist, L., Frisell, J. & de Boniface, J. (2018). Long-term breast cancer survival in relation to the metastatic tumor burden in axillary lymph nodes. Breast Cancer Research and Treatment, 171(2), 359-369
Open this publication in new window or tab >>Long-term breast cancer survival in relation to the metastatic tumor burden in axillary lymph nodes
2018 (English)In: Breast Cancer Research and Treatment, ISSN 0167-6806, E-ISSN 1573-7217, Vol. 171, no 2, p. 359-369Article in journal (Refereed) Published
Abstract [en]

Purpose: The clinical significance of lymph node micrometastases and isolated tumor cells (ITCs) in breast cancer is still controversial. After a median follow-up of 52 months, a report from the Swedish Multicenter Cohort Study presented a worse cancer-specific and event-free survival for patients with micrometastases than node-negative individuals, but could not demonstrate a significant difference in overall survival (OS). Due to the tendency of breast cancer to relapse after more than 5-10 years, we now report the long-term survival of the cohort.

Methods: Between September 2000 and January 2004, 3355 breast cancer patients were included in a prospective cohort. Sentinel lymph node biopsy was always performed. Patients were classified in four groups according to their overall nodal stage: node negative (N0, 2372), ITCs (113), micrometastases (123), and macrometastases (747). Kaplan-Meier survival estimates and Cox proportional hazard regression models were applied.

Results: Median follow-up was 156 months. Ten-year cancer-specific survival and OS were significantly lower in case of micrometastases than in N0 (84.7 vs. 93.5%, p = 0.001, and 75.5 vs. 84.2%, p = 0.046, respectively). In case of macrometastases, corresponding survival rates were 82.8 and 74.3%. Only for those aged less than 50 years, cancer-specific survival and OS were significantly worse in case of ITCs than N0. Patients with micrometastases received less often chemotherapy than those with macrometastases (24.4 vs. 53.9%).

Conclusions: Lymph node micrometastases in breast cancer have a prognostic significance. This study demonstrates a similar survival for patients with micrometastases and those with macrometastases, possibly due to systemic undertreatment.

Keywords
Breast cancer, Sentinel node biopsy, Lymph node status, Micrometastases, Isolated tumor cells, Prognosis
National Category
Cancer and Oncology Surgery
Identifiers
urn:nbn:se:uu:diva-363095 (URN)10.1007/s10549-018-4820-0 (DOI)000440766500011 ()29846847 (PubMedID)
Funder
The Breast Cancer FoundationSwedish Cancer SocietySwedish Society for Medical Research (SSMF)
Available from: 2018-10-16 Created: 2018-10-16 Last updated: 2018-10-16Bibliographically approved
Karakatsanis, A., Olofsson, H., Stålberg, P., Bergkvist, L., Abdsaleh, S. & Wärnberg, F. (2018). Simplifying Logistics and Avoiding the Unnecessary in Patients with Breast Cancer Undergoing Sentinel Node Biopsy. A Prospective Feasibility Trial of the Preoperative Injection of Super Paramagnetic Iron Oxide Nanoparticles. Scandinavian Journal of Surgery, 107(2), 130-137
Open this publication in new window or tab >>Simplifying Logistics and Avoiding the Unnecessary in Patients with Breast Cancer Undergoing Sentinel Node Biopsy. A Prospective Feasibility Trial of the Preoperative Injection of Super Paramagnetic Iron Oxide Nanoparticles
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2018 (English)In: Scandinavian Journal of Surgery, ISSN 1457-4969, E-ISSN 1799-7267, Vol. 107, no 2, p. 130-137Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Sentinel node is routinely localized with the intraoperative use of a radioactive tracer, involving challenging logistics. Super paramagnetic iron oxide nanoparticle is a non-radioactive tracer with comparable performance that could allow for preoperative localization, would simplify the procedure, and possibly be of value in axillary mapping before neoadjuvant treatment. The current trial aimed to determine the a priori hypothesis that the injection of super paramagnetic iron oxide nanoparticles in the preoperative period for the localization of the sentinel node is feasible.

METHODS: This is a prospective feasibility trial, conducted from 9 September 2014 to 22 October 2014 at Uppsala University Hospital. In all, 12 consecutive patients with primary breast cancer planned for resection of the primary and sentinel node biopsy were recruited. Super paramagnetic iron oxide nanoparticles were injected in the preoperative visit in the outpatient clinic. The radioactive tracer (99mTc) and the blue dye were injected perioperatively in standard fashion. A volunteer was injected with super paramagnetic iron oxide nanoparticles to follow the decline in the magnetic signal in the sentinel node over time. The primary outcome was successful sentinel node detection.

RESULTS: Super paramagnetic iron oxide nanoparticles' detection after preoperative injection (3-15 days) was successful in all cases (100%). In the volunteer, axillary signal was presented for 4 weeks. No adverse effects were noted. Conclusion and relevance: Preoperative super paramagnetic iron oxide nanoparticles' injection is feasible and leads to successful detection of the sentinel node. That may lead to simplified logistics as well as the identification, sampling, and marking of the sentinel node in patients planned for neoadjuvant treatment.

Keywords
Super paramagnetic iron oxide, breast cancer, novel technique, sentinel node biopsy
National Category
Clinical Medicine Medical and Health Sciences Clinical Laboratory Medicine
Research subject
Surgery; Pathology
Identifiers
urn:nbn:se:uu:diva-335970 (URN)10.1177/1457496917738867 (DOI)000432717600006 ()29132268 (PubMedID)
Available from: 2017-12-11 Created: 2017-12-11 Last updated: 2019-04-02Bibliographically approved
Söderström, L., Rosenblad, A., Thors Adolfsson, E. & Bergkvist, L. (2017). Malnutrition is associated with increased mortality in older adults regardless of the cause of death. British Journal of Nutrition, 117(4), 532-540
Open this publication in new window or tab >>Malnutrition is associated with increased mortality in older adults regardless of the cause of death
2017 (English)In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 117, no 4, p. 532-540Article in journal (Refereed) Published
Abstract [en]

Malnutrition predicts preterm death, but whether this is valid irrespective of the cause of death is unknown. The aim of the present study was to determine whether malnutrition is associated with cause-specific mortality in older adults. This cohort study was conducted in Sweden and included 1767 individuals aged >= 65 years admitted to hospital in 2008-2009. On the basis of the Mini Nutritional Assessment instrument, nutritional risk was assessed as well nourished (score 24-30), at risk of malnutrition (score 17-23.5) or malnourished (score < 17). Cause of death was classified according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, into twenty different causes of death. Data were analysed using Cox proportional hazards regression models. At baseline, 55.1% were at risk of malnutrition, and 9.4% of the participants were malnourished. During a median follow-up of 5.1 years, 839 participants (47.5%) died. The multiple Cox regression model identified significant associations (hazard ratio (HR)) between malnutrition and risk of malnutrition, respectively, and death due to neoplasms (HR 2.43 and 1.32); mental or behavioural disorders (HR 5.73 and 5.44); diseases of the nervous (HR 4.39 and 2.08), circulatory (HR 1.95 and 1.57) or respiratory system (HR 2.19 and 1.49); and symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (HR 2.23 and 1.43). Malnutrition and risk of malnutrition are associated with increased mortality regardless of the cause of death, which emphasises the need for nutritional screening to identify older adults who may require nutritional support in order to avoid preterm death.

Keywords
cause-specific mortality, malnutrition, Mini Nutritional Assessment, malnutrition, older adults, survival analysis
National Category
Nutrition and Dietetics
Research subject
Nutrition
Identifiers
urn:nbn:se:uu:diva-267556 (URN)10.1017/S0007114517000435 (DOI)000399336800006 ()28290264 (PubMedID)
Funder
Swedish National Board of Health and Welfare, 11132/2011
Available from: 2015-11-24 Created: 2015-11-24 Last updated: 2017-05-15Bibliographically approved
Karakatsanis, A., Olofsson, H. M., Eriksson, S., Andersson, Y., Bergkvist, L. A., Mohammed, I., . . . Wärnberg, F. (2017). SentiNot: A way to avoid sentinel node biopsy (SNB) in patients with a preoperative diagnosis of ductal cancer in situ (DCIS). Paper presented at San Antonio Breast Cancer Symposium, DEC 06-10, 2016, San Antonio, TX. Cancer Research, 77
Open this publication in new window or tab >>SentiNot: A way to avoid sentinel node biopsy (SNB) in patients with a preoperative diagnosis of ductal cancer in situ (DCIS)
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2017 (English)In: Cancer Research, ISSN 0008-5472, E-ISSN 1538-7445, Vol. 77Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Univ Uppsala Hosp, Sect Endocrine & Breast Surg, Uppsala, Sweden. Univ Uppsala Hosp, Uppsala, Sweden. Vastmanland Cty Hosp, Vasteras, Vasteras, Sweden. Uppsala Clin Res Ctr, Uppsala, Sweden. Kalmar Cty Hosp, Sect Breast Surg, Kalmar, Sweden. Univ Uppsala Hosp, Inst Radiol Oncol & Radiotherapy, Uppsala, Sweden. Norrlands Univ Hosp, Umea, Sweden.: AMER ASSOC CANCER RESEARCH, 2017
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-320979 (URN)10.1158/1538-7445.SABCS16-P2-01-19 (DOI)000397999000308 ()
Conference
San Antonio Breast Cancer Symposium, DEC 06-10, 2016, San Antonio, TX
Available from: 2017-04-27 Created: 2017-04-27 Last updated: 2017-04-27Bibliographically approved
Karakatsanis, A., Daskalakis, K., Stålberg, P., Olofsson, H., Andersson, Y., Eriksson, S., . . . Wärnberg, F. (2017). Superparamagnetic iron oxide nanoparticles as the sole method for sentinel node biopsy detection in patients with breast cancer. British Journal of Surgery, 104(12), 1675-1685
Open this publication in new window or tab >>Superparamagnetic iron oxide nanoparticles as the sole method for sentinel node biopsy detection in patients with breast cancer
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2017 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 104, no 12, p. 1675-1685Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Sentinel node biopsy (SNB) using superparamagnetic iron oxide (SPIO) nanoparticles is a novel method in breast cancer. Several studies have verified the non-inferiority of SPIO compared with the standard use of radioisotope (99m) Tc with or without blue dye. The aim of the MONOS study presented here was to evaluate the use of SPIO as a sole tracer and the efficacy of tracer injection in the preoperative setting.

METHODS: This prospective cohort study was carried out in two hospitals, one using (99m) Tc and the other SPIO. (99m) Tc was injected in the morning of the day of surgery or the day before. SPIO was either injected before surgery in the outpatient clinic or 1 h before the operation.

RESULTS: A total of 338 consecutive patients with breast cancer underwent 343 procedures; SPIO nanoparticles were used in 184 procedures and (99m) Tc-labelled tracer in 159. Detection rates for SPIO and (99m) Tc were 95·6 and 96·9 per cent respectively (P = 0·537). All nodes with SPIO uptake were coloured brown. Fewer nodes were retrieved with SPIO (mean 1·35 versus 1·89), regardless of whether blue dye was used (P < 0·001). Preoperative SPIO injection (58·7 per cent of procedures), a median of 16 (range 2-27) days before the procedure, was associated with a better tracer-specific detection rate (95·3 versus 86 per cent; P = 0·031) and retrieval of more nodes (mean 1·43 versus 1·03; P < 0·001) than perioperative administration. Skin staining was present in 39·9 per cent of patients, and was related to breast-conserving surgery and periareolar injection.

CONCLUSION: The use of SPIO alone is a safe alternative, with results comparable to those of the standard dual technique using (99m) Tc and blue dye. The efficacy of injection in the preoperative setting simplifies logistics and improves performance. Skin staining can be prevented by a deeper peritumoral injection.

National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-333258 (URN)10.1002/bjs.10606 (DOI)000413157100012 ()28877348 (PubMedID)
Available from: 2017-11-09 Created: 2017-11-09 Last updated: 2018-08-26Bibliographically approved
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