A Comparison of Skin Staining after Sentinel Lymph Node Biopsy in Women Undergoing Breast Cancer Surgery Using Blue Dye and Superparamagnetic Iron Oxide Nanoparticle (SPIO) Tracers

• Published in: Cancers Vol. 14; no. 23; p. 6017
• Main Authors: Jazrawi, Allan, Wärnberg, Madeleine, Hersi, Abdi-Fatah, Obondo, Christine, Pistioli, Lida, Eriksson, Staffan, Karakatsanis, Andreas, Wärnberg, Fredrik
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 06-12-2022; MDPI
• Subjects: Biopsy; blue dye; Breast cancer; Care and treatment; Comparative analysis; Complications and side effects; Confidence intervals; Dyes; Injection; Iron oxides; Lumpectomy; Lymph nodes; Lymphatic system; magnetic tracer; Mastectomy; Nanoparticles; Patients; Radioactive tracers; Risk factors; sentinel lymph node; sentinel lymph node biopsy; Skin; Skin diseases; skin staining; Stains & staining; Statistical analysis; superparamagnetic iron oxide; Surgeons; Surgery; Tracers; Women; Sweden; blue dye; skin staining; sentinel lymph node biopsy; superparamagnetic iron oxide; breast cancer; sentinel lymph node; magnetic tracer
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers14236017

Superparamagnetic iron oxide nanoparticles (SPIO) are a tracer for sentinel lymph node (SLN) detection. In a preplanned secondary analysis of a prospective clinical trial (SentiDose) we reported on skin staining after SPIO and blue dye (BD) injections. For SPIO, either a 1.5 mL retroareolar injection on the day of surgery or a 1.0 mL peritumoral/retroareolar injection 1-7 days before surgery was given. A 1.0 mL sub-/intradermal periareolar injection of BD was also administered to all these women. Staining was then assessed at 6, 12 and 24 months after surgery. A total of 270 women received SPIO and were operated on with breast-conserving surgery. Of these, 204 women also received BD. A total of 58 (21.5%) women had an SPIO stain 6 months postoperatively with a median size of 6.8 cm
(
= 0.56), while 51 (25.0%) had a BD stain with a median size of 8.5 cm
(
= 0.93). The incidence and size of SPIO and BD staining decreased over time reciprocally. At 24 months, the incidence and median size of SPIO was 23 (8.6%) and 4 cm
, respectively. For BD, the incidence was 14 (6.3%,
= 0.13), and the median size was 3.5 cm
(
= 0.18). There was, therefore, no statistically significant difference in the incidence or size of skin staining between SPIO and BD over time.