Match detection analysis on SentiMag® system and standard technique in SLNB of breast cancer

Abstract

Introduction

In breast cancer surgery, there are techniques for sentinel lymph node biopsy (SLNB) that do not require Nuclear Medicine, such SentiMag®, which uses ferromagnetic particles. The main purpose of this analysis is to study the degree of concordance in SLNB between SentiMag® and the standard method (Tc99 radiotracer). The secondary objective is to identify factors that impact in sentinel node detection rate and matching detection rate between both probes.

Methods

Observational and retrospective study performed from January to December 2021 focused on patients undergoing breast surgery and SLNB who were injected with both tracers, the ferromagnetic SentiMag® and Tc99 radiotracer. Once the diagnostic accuracy tests were performed, a further evaluation of the detection rate for each probe and the concordance between probes were accomplished. After those results, a deeper analysis of differences in detection rates for each probe and concordance between probes were assessed for various factors: neoadjuvant therapy, BMI, mitotic index, and triple-negative immunohistochemical profile.

Results

The clinical study had a sample size of 70 patients. The overall false-negative rate (FNR) was 4.3%. The detection rate was the same for each technique (85.7%). A total of 106 nodes were biopsied, with a concordance rate of 70.75%. Significant differences were found in concordant nodes according to neoadjuvant therapy (p-value 0.012). For the Ki-67 factor (<20 or ≥20), significant differences were found in detected nodes (p-value 0.031 gamma probe; p-value 0.124 SentiMag®).

Conclusions

The detection rates of SentiMag® and the gamma probe are equivalent. The application of the dual technique minimizes the FNR. A high mitotic index affects the detection rate of the gamma probe, and neoadjuvant therapy negatively impacts the concordance rate.