A multicentre prospective feasibility study of carbon dye tattooing of biopsied axillary node and surgical localisation
- PDF / 938,482 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 83 Downloads / 144 Views
CLINICAL TRIAL
A multicentre prospective feasibility study of carbon dye tattooing of biopsied axillary node and surgical localisation in breast cancer patients Amit Goyal1 · Shama Puri2 · Andrea Marshall3 · Kalliope Valassiadou4 · Moin M. Hoosein5 · Amtul R. Carmichael6 · Gabriella Erdelyi2 · Nisha Sharma7 · Janet Dunn3 · Joanne York2 Received: 3 August 2020 / Accepted: 29 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background The primary aim of this prospective, multicentre feasibility study was to determine whether the biopsied axillary node can be marked using black carbon dye and successfully identified at the time of surgery. Methods We included breast cancer patients undergoing needle biopsy of the axillary node. The biopsied node was tattooed at the time of needle biopsy (fine needle aspiration or core biopsy) or at a separate visit with black carbon dye (Spot® or Black Eye™). Participants underwent primary surgery or neoadjuvant chemotherapy (NACT) and axillary surgery (SNB or ALND) as per routine care. Results 110 patients were included. Median age of the women was 59 (range 31–88) years. 48 (44%) underwent SNB and 62 (56%) ALND. Median volume of dye injected was 2.0 ml (range 0.2–4.2). Tattooed node was identified intra-operatively in 90 (82%) patients. The identification rate was higher (76 of 88, 86%) in the primary surgery group compared with NACT (14 of 22, 64%) (p = 0.03). Of those undergoing NACT, the identification rate was better in the patients undergoing SNB (3 of 4, 75%) compared with ALND (11 of 18, 61%) (p > 0.99). The tattooed node was the sentinel node in 78% (28 of 36) patients in the primary surgery group and 100% (3 of 3) in the NACT group. There was no learning curve for surgeons or radiologists. The identification rate did not vary with timing between dye injection and surgery (p = 0.56), body mass index (p = 0.62) or volume of dye injected (p = 0.25). Conclusion It is feasible to mark the axillary node with carbon dye and identify it intra-operatively. ClinicalTrials.gov: NCT03640819. Keywords Carbon dye · Breast cancer · Sentinel node biopsy · Tattooing · Neoadjuvant chemotherapy · Targeted axillary dissection · Axillary staging
* Amit Goyal [email protected] 1
Department of Surgery, Royal Derby Hospital, Uttoxeter Road, Derby DE22 3NE, UK
2
Department of Radiology, Royal Derby Hospital, Derby, UK
3
Warwick Clinical Trials Unit, University of Warwick, Warwick, UK
4
Department of Surgery, University Hospitals, Leicester, UK
5
Department of Radiology, University Hospitals, Leicester, UK
6
Department of Surgery, Queens Hospital, Burton‑on‑Trent, UK
7
Department of Radiology, St James’s University Hospital, Leeds, UK
Introduction We have witnessed de-escalation of axillary surgery in the last two decades. Sentinel node biopsy (SNB) has become the procedure of choice for axillary staging in patients who are clinically node negative at presentation irrespective of whether they undergo primary surgery or neo
Data Loading...
