Immediate results of sentinel lymph nodes biopsy using technetium-99-labeled colloidal albumin – 99mTc-Nanotope as a lymphotropic radiopharmaceutical in patients with early stages of breast cancer (T1-2N0M0)

«Radiation and Risk», 2025, vol. 34, No. 4, pp.129-137

DOI: 10.21870/0131-3878-2025-34-4-129-137

Authors

Dobrenkiy M.N. – Prof. of Dep., MD, Honored Doctor of RF
Dobrenkaya E.M. – Assoc. Prof. of Dep., C. Sc., Med. Astrakhan SMU. Contacts: 121 Bakinskaya str., Astrakhan, Russia, 414000. Tel.: +7(927)561-52-95; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. .
Kachanov I.V. – Head of Dep., C. Sc., Med. Regional Clinical Oncological Dispensary.
¹ Astrakhan State Medical University of the Ministry of Health of the Russian Federation, Astrakhan
² Regional Clinical Oncological Dispensary, Astrakhan

Abstract

The status of lymph nodes is an important prognostic factor for survival in breast cancer. The scope of treatment measures depends on the number of affected lymph nodes and determines the planning of additional treatment. In the absence of metastases in the lymph nodes, there is no need for axillary lymphadenectomy or radiation therapy to this area, since these procedures can lead to postoperative complications and prolonged wound healing. Therefore, patients with no metastases in the sentinel lymph nodes undergo surgery in the volume of radical resection of the breast, and in case of metastases in the sentinel lymph nodes – radical resection of the breast with full standard lymph node dissection. We present the experience of using a radiopharmaceutical labeled with technetium-99 colloidal albumin – ^99mTc-Nanotop (ROTOP-pharma GmbH, Germany) for the detection of sentinel lymph nodes using the combined Discovery NM/CT 670 system by General Electric. When evaluating scintigrams, we focused on the presence of fixation of the radiopharmaceutical at the site of its injection and areas of hyperfixation in case of metastasis in the sentinel lymph nodes. During the operation, the search was performed followed by biopsy of the sentinel node using a portable gamma scanner Rad Pointer Gamma on 453 patients with early stage breast cancer (T1-2N0M0) treated at the Regional Clinical Oncology Dispensary in Astrakhan in 2021-2024. The study demonstrated the high diagnostic effectiveness of ^99mTc-Nanotop, its ease of use, safety, and low risk of radiation ex-posure. Radionuclide visualization for detecting sentinel lymph nodes is a highly effective diagnostic method that allows avoiding unnecessary lymphadenectomies, postoperative complications in the future, improving the quality of life, and reducing permanent disability without compromising the rad-icality of the performed operations.

Key words
oncology, radiology, breast cancer, early stages, 99mTc-Nanotop, SPECT/СT, low risk of radiation exposure, lymphoscintigraphy, sentinel lymph node, biopsy, lymph node dissection, volume of surgical treatment, nuclear medicine and imaging.

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