Optimal timing of sentinel node detection using 99mTc Tc-phytate lymphoscintigraphy: A study of 100 breast cancer patients

Abstract

Introduction: Sentinel lymph node biopsy guided by preoperative lymphoscintigraphy is an established technique for axillary staging in breast cancer. However, the optimal timing for lymphoscintigraphic imaging remains unclear. Earlier acquisition may expedite surgery while later imaging improves detection rates by allowing radiotracer transit. Defining the timeframe maximizing accuracy and minimizing burden is needed. Objective: To evaluate optimal acquisition timings for 99mTcTc-Phytate lymphoscintigraphy in sentinel lymph node mapping for breast cancer. Methods: Hundred breast cancer patients underwent periareolar injection of 1-2 mCi 99mTc Tc-Phytate and lymphoscintigraphy at 5,10, 30, 60 and 120 min post-injection. Lymph node visualization was assessed by experienced nuclear medicine physicians based on retrospective review of scintigraphy images. Descriptive statistics characterized patient demographics and time to sentinel lymph node detection. Correlation analyses evaluated relationships between visualization parameters and factors such as age, sex and surgical history. Results: Lymph nodes were typically visible within 10 min (median). Regression found no significant predictors of prolonged transit time among age, sex, surgical history. Age is not a statistically significant predictor of node visualization (p = 0.129). Also sex and surgery history are not significant predictors of longer time (p > 0.05). Conclusion: Sentinel lymph node biopsy guided by lymphoscintigraphy is an important technique for axillary staging in breast cancer. Standardizing acquisition timing could optimize the accuracy and efficiency of lymphoscintigraphy for axillary staging. (c) 2025 SESPM. Published by Elsevier Espana, S.L.U. All rights are reserved, including those for text and data mining, AI training, and similar technologies.