99mTc-rituximab as a tracer for sentinel lymph node biopsy in breast cancer patients: a single-center analysis

Breast Cancer Res Treat. 2018 Apr;168(2):365-370. doi: 10.1007/s10549-017-4591-z. Epub 2017 Dec 6.

Abstract

Purpose: This study aimed to determine the long-term prognosis of breast cancer patients with 99mTc-rituximab for sentinel lymph node biopsy (SLNB).

Methods: A total of 2947 patients with negative sentinel lymph nodes (SLNs) omitting axillary lymph node dissection (ALND), treated between June 2005 and December 2013, were retrospectively analyzed. SLNB was performed prior to adjuvant therapy.

Results: After a median follow-up of 62 months, 22 cases of axillary recurrence (AR) were observed. The 5-year AR rate (ARR) was 0.7% [95% confidence interval (CI) 0.3-1.1%] and the 5-year relapse-free survival (RFS) was 95.2% (95% CI 94.4-96.0%). Multivariate analysis showed that abnormal axillary ultrasound with negative fine-needle aspiration (FNA) [hazard ratio (HR) 3.79, 95% CI 1.55-9.28; P = 0.004], not receiving radiotherapy (HR 4.38, 95% CI 1.47-13.05; P = 0.008), and age ≤ 40 years (HR 2.93, 95% CI 1.19-7.20; P = 0.020) were independent risk factors for AR.

Conclusions: ARR of SLNB-negative patients with 99mTc-rituximab is low. Abnormal axillary ultrasound with negative FNA, not receiving radiotherapy, and age ≤ 40 years were prognostic factors for higher ARRs.

Keywords: 99mTc-rituximab; Axillary recurrence; Breast cancer; Sentinel lymph node biopsy.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal, Murine-Derived / administration & dosage*
  • Antineoplastic Agents / therapeutic use
  • Axilla / diagnostic imaging
  • Biopsy, Fine-Needle
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / therapy
  • Chemotherapy, Adjuvant / methods
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Lymphatic Metastasis / diagnosis*
  • Lymphatic Metastasis / pathology
  • Mastectomy / methods
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Recurrence, Local / pathology
  • Organotechnetium Compounds / administration & dosage*
  • Prognosis
  • Radioactive Tracers
  • Retrospective Studies
  • Rituximab / administration & dosage*
  • Sentinel Lymph Node / diagnostic imaging*
  • Sentinel Lymph Node / pathology
  • Sentinel Lymph Node / surgery
  • Sentinel Lymph Node Biopsy / methods*
  • Ultrasonography
  • Young Adult

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Antineoplastic Agents
  • Organotechnetium Compounds
  • Radioactive Tracers
  • technetium 99m rituximab
  • Rituximab