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Annals of Oncology Advance Access originally published online on February 2, 2005
Annals of Oncology 2005 16(4):674; doi:10.1093/annonc/mdi108
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© 2005 European Society for Medical Oncology

Letters

Lymphoscintigraphy in pregnant patients with breast cancer: is it really safe?

I. Tek*, A. Büyükçelik, B. Yalçin and H. Akbulut

Ankara University School of Medicine, Department of Medical Oncology, Ibni Sina Hospital, 06 100-TR, Sihhiye, Ankara, Turkey

* Email: itekmd{at}yahoo.com

In their recent study, Gentilini et al. [1Go] investigated the safety of lymphoscintigraphy and sentinel node biopsy in pregnant women with breast cancer. After peritumoral injection of 12 MBq 99mTc-HSA nanocolloids, static and whole-body scintigraphic images were acquired. Concentration of radioactivity in the urine and bloodstream was measured using a gamma counter. Scintigraphic images showed radiotracer concentration at only the injection site and the sentinel node. Total activity was excreted via the urine within 16 h and activity in the blood pool at each time point was <2% and <1% of the injected activity, respectively. Gentilini et al. concluded that, according to their standard technique, lymphoscintigraphy and sentinel lymph node biopsy can be performed safely in pregnant women with breast cancer. However, this conclusion is fairly questionable.

As pointed out by Gentilini et al., their study was of non-pregnant women. The distribution and excretion of 99mTc-HSA nanocolloids in pregnant women are not known, and it is not logical to investigate the pharmacodynamics of 99mTc-HSA nanocolloids (due to radioactivity of 99mTc-HSA non-colloids) in pregnant women. The uterus is located next to the urinary bladder; therefore, the accumulation of the gamma radiation of 99mTc, which has high penetration activity, could possibly be harmful to the fetus. It is therefore difficult to apply the results of an article studying non-pregnant women to pregnant women.


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1. Gentilini O, Cremonesi M, Trifiro G et al. Safety of sentinel node biopsy in pregnant patients with breast cancer. Ann Oncol 2004; 15: 1348–1351.[Abstract/Free Full Text]


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N. Pandit-Taskar, L. T. Dauer, L. Montgomery, J. St. Germain, P. B. Zanzonico, and C. R. Divgi
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[Abstract] [Full Text] [PDF]

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