This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Superparamagnetic iron oxide nanoparticles as the sole method for sentinel node biopsy detection in patients with breast cancer. BJS 2017; 104: 1675-1685.
Published: 6th September 2017
Authors: A. Karakatsanis, K. Daskalakis, P. Stålberg, H. Olofsson, Y. Andersson, S. Eriksson et al.
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 99mTc 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.
Method
This prospective cohort study was carried out in two hospitals, one using 99mTc and the other SPIO. 99mTc 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 99mTc‐labelled tracer in 159. Detection rates for SPIO and 99mTc were 95·6 and 96·9 per cent respectively (
Conclusion
The use of SPIO alone is a safe alternative, with results comparable to those of the standard dual technique using 99mTc 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.
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