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The Nordic SentiMag trial: a comparison of super paramagnetic iron oxide (SPIO) nanoparticles versus Tc-99 and patent blue in the detection of sentinel node (SN) in patients with breast cancer and a meta-analysis of earlier studies
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Endocrine Surgery.
Aarhus Univ Hosp, Randers Reg Hosp, Dept Surg, Breast Unit, DK-8000 Aarhus, Denmark..
Aarhus Univ Hosp, Randers Reg Hosp, Dept Surg, Breast Unit, DK-8000 Aarhus, Denmark..
Linkoping Univ Hosp, Dept Surg, Breast Unit, S-58185 Linkoping, Sweden..
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2016 (English)In: Breast Cancer Research and Treatment, ISSN 0167-6806, E-ISSN 1573-7217, Vol. 157, no 2, 281-294 p.Article in journal (Refereed) Published
Abstract [en]

The aim of the study is to compare the efficacy of SPIO as a tracer in sentinel node biopsy (SNB) in breast cancer with Tc and patent blue in a multicentre prospective study and perform a meta-analysis of all published studies. It also aims to follow skin discoloration after SPIO injection and describe when and how it resolves. Totally 206 patients with early breast cancer were recruited. Tc and patent blue were administered in standard fashion. Patients were injected with SPIO (Sienna+) preoperatively. SNB was performed and detection rates were recorded for both methods. Skin discoloration was followed and documented postoperatively. Data extraction and subsequent meta-analysis of all previous studies were also performed. SN detection rates were similar between standard technique succeeded and SPIO both per patient (97.1 vs. 97.6 %, p = 0.76) as well as per node (91.3 vs. 93.3 %, p = 0.34), something which was not affected by the presence of malignancy. Concordance rates were also consistently high (98.0 % per patient and 95.9 % per node). Discoloring was present in 35.5 % of patients postoperatively, almost exclusively in breast conservation. It fades slowly and is still detectable in 8.6 % of patients after 15 months. Meta-analysis depicted similar detection rates (p = 0.71) and concordance rates (p = 0.82) per patient. However, it seems that SPIO is characterized by higher nodal retrieval (p < 0.001). SPIO is an effective method for the detection of SN in patients with breast cancer. It is comparable to the standard technique and seems to simplify logistics. Potential skin discoloration is something of consideration in patients planned for breast conservation.

Place, publisher, year, edition, pages
2016. Vol. 157, no 2, 281-294 p.
Keyword [en]
Sentinel node, Super paramagnetic iron oxide, Breast cancer
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-302226DOI: 10.1007/s10549-016-3809-9ISI: 000376580900008PubMedID: 27117158OAI: oai:DiVA.org:uu-302226DiVA: diva2:957103
Available from: 2016-09-01 Created: 2016-08-31 Last updated: 2016-09-01Bibliographically approved

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Karakatsanis, AndreasDaskalakis, KosmasWärnberg, FredrikBergkvist, Leif
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Endocrine SurgeryCentre for Clinical Research, County of Västmanland
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Breast Cancer Research and Treatment
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