Miami Breast Cancer Conference 2021: Comparing Radiolabeled Mapping Agents in Identifying Sentinel Lymph Nodes
Posted: Friday, March 12, 2021
Standard practice for identifying sentinel lymph nodes during biopsy involves preoperative injection of a radiolabeled mapping agent. Technetium-labeled sulfur colloid and 99m-Tc tilmanocept seemed to harvest similar numbers of sentinel lymph nodes in patients with breast cancer, according to Anyul Ferez-Pinzon, MD, of the Memorial Health University Medical Center, Savannah, Georgia, and colleagues. The results of this double-blind, randomized trial, which were presented during the virtual edition of the 2021 PER’s Miami Breast Cancer Conference (Abstract 05), also revealed that the duration of time to the first transcutaneous localization did not seem to significantly differ between the two intraoperative radiolabeled mapping agents.
“Tilmanocept is a CD-206 receptor–targeted mapping agent that has recently gained popularity due to potential advantages of rapid and tight binding to the sentinel lymph nodes,” the investigators commented. “These attributes may be beneficial when using an intraoperative injection protocol, where there is shorter time to localization.”
In this trial, patients who were undergoing partial mastectomy with sentinel lymph node biopsy were randomly assigned to receive an intradermal injection of filtered technetium-labeled sulfur colloid (n = 38) or tilmanocept (n = 48) after the induction of general anesthesia.
The localization rate was 100% with both technetium-labeled sulfur colloid and tilmanocept. The average number of sentinel lymph nodes identified and removed did not seem to significantly differ between the mapping agents (intraoperative: P = .34; final pathology report: P = .57). The average time to transcutaneous localization was 3.3 minutes with tilmanocept and 3.9 minutes with technetium-labeled sulfur colloid (P = .19). Compared with tilmanocept, the average counts per second for the hottest node was higher with technetium-labeled sulfur colloid (2,180 vs. 2,679, respectively; P = .94).
Disclosure: No information regarding conflicts of interest was provided.
