The Role of Intra-Operative Mobile Gamma Camera and Gamma Probe in Detection of Sentinel Lymph Node in Early Stage Breast Cancer

Author(s): Maher H Ibraheem, Mohamed Gamil, Ahmed Tantawy, Omnia Talaat, Rimoun Boutrrus, Mohammed Mohammed Mohammed Gomaa

Background: The use of intraoperative mobile gamma camera that provide real-time intraoperative images of the sentinel lymph node (SLN), in combination with hand held gamma probe, is assumed to increase the accuracy of yielding the SLN, in early breast cancer patients, with more proper site localization.

Purpose: To assess the added value of intraoperative mobile gamma camera in combination with hand held gamma probe in detection of SLN(s) in early stage breast cancer patients.

Methods: It was a prospective study on 30 patients, with breast cancer scheduled SLN. biopsy in the National Cancer Institute, Cairo University, Egypt. From January 2015 till December 2015. A new device (intraoperative mobile gamma camera) was used in conjunction with a gamma probe in early stage breast cancer patients.

Results: The hand held gamma probe detected SLNs in 28 out of 30 (93.4%) patients, while the intraoperative mobile gamma camera detected SLN(s) in 29 patients out of 30 (96.7%) patients. In total, 59 SLNs were found using the gamma probe, and 62 SLNs were found using the mobile gamma camera. For patients whom underwent a SLNB, the pain in axilla ranged from 1 to 3, while the severity reached 6 and 7 in the two patients who underwent axillary dissection.

Conclusion: The use of intraoperative mobile gamma camera in conjunction with the handheld gamma probe resulted in a higher SLN detection rate, made the SLNB more accurate with proper site localization, either axillary or extra axillary sites and with less complications.