Clinical study of 99mTc-Rituximab combined with dyes double tracing for axillary sentinel lymph node biopsy after neoadjuvant chemotherapy for breast cancer

Background and objectiveWhether sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) for breast cancer is an alternative to axillary lymph node dissection (ALND) remains controversial. In this study, the results of SLNB performed with 99mTc-Rituximab combined with dyes were analyze...

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Main Authors: Minxue Zhuang, Yidan Lin, HongBin Qiu, Wei Chen, Ruo Wang, HuanHong Zeng, Mengbo Lin, Hui Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1568550/full
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author Minxue Zhuang
Minxue Zhuang
Yidan Lin
HongBin Qiu
HongBin Qiu
Wei Chen
Wei Chen
Ruo Wang
Ruo Wang
HuanHong Zeng
HuanHong Zeng
Mengbo Lin
Mengbo Lin
Hui Zhang
Hui Zhang
author_facet Minxue Zhuang
Minxue Zhuang
Yidan Lin
HongBin Qiu
HongBin Qiu
Wei Chen
Wei Chen
Ruo Wang
Ruo Wang
HuanHong Zeng
HuanHong Zeng
Mengbo Lin
Mengbo Lin
Hui Zhang
Hui Zhang
author_sort Minxue Zhuang
collection DOAJ
description Background and objectiveWhether sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) for breast cancer is an alternative to axillary lymph node dissection (ALND) remains controversial. In this study, the results of SLNB performed with 99mTc-Rituximab combined with dyes were analyzed, and the application value of the double-tracing method of 99mTc-Rituximab combined with dyes in SLNB after breast cancer NAC was evaluated, the feasibility of SLNB after NAC and the clinical application of the novel tracer 99mTc-Rituximab and its value in internal mammary lymph node(IMLN) was discussed.MethodsA retrospective analysis of 106 breast cancer patients who underwent post-NAC SLNB from August 2019 to August 2023 at Fujian Provincial Hospital, where SLNB was performed using 99mTc-Rituximab combined with dye imaging or dye imaging alone. The detection rate, sensitivity, false-negative rate, accuracy and the detection rate of internal mammary lymph node(IMLN) biopsy were compared between the two tracing methods.Results70 cases were included in the dual-tracer group, with a detection rate of 97.14% (68/70), an average number of detected SLNs of (6.06 ± 5.29), a sensitivity of 92.86% (26/28), a false negative rate of 7.14% (2/28), and an accuracy of 97.14% (68/70). 36 cases were included in the single-tracer group, with a detection rate of 66.67% (24/36), an average number of detected SLNs of (3.17 ± 3.073), a sensitivity of 54.55% (11/22), a false negative rate of 45.45% (10/22), and an accuracy of 72.22% (26/36). There were significant differences in the detection rate and the average number of detected SLNs between the two groups (detection rate: P=0.004; detection number: P=0.038), but there were no significant differences in the sensitivity, accuracy, and false negative rate (P>0.05). A total of 70 patients were examined for internal mammary lymph node biopsy with dual tracer, and 22 patients were detected with an imaging rate of 31.42% (22/70), and a detection rate of 72.72% (16/22).ConclusionsFor patients with breast cancer, the dual-tracer method combining radionuclide and dye for SNLB after neoadjuvant chemotherapy can improve the detection rate of sentinel lymph nodes and reduce the false-negative rate. In the long term, the quality of life of patients can be helped to improve by this approach. Compared with other tracers, 99mTc-Rituximab can improve the detection rate of internal mammary lymph nodes, with the characteristics of rapid clearance of injection site, less secondary lymph node visualization, and hypoallergenicity, which can be used as an ideal tracer for further research.
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spelling doaj-art-b6ff24b9c3514ab4aeb7bc01a6dbde012025-08-20T03:59:22ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-08-011510.3389/fonc.2025.15685501568550Clinical study of 99mTc-Rituximab combined with dyes double tracing for axillary sentinel lymph node biopsy after neoadjuvant chemotherapy for breast cancerMinxue Zhuang0Minxue Zhuang1Yidan Lin2HongBin Qiu3HongBin Qiu4Wei Chen5Wei Chen6Ruo Wang7Ruo Wang8HuanHong Zeng9HuanHong Zeng10Mengbo Lin11Mengbo Lin12Hui Zhang13Hui Zhang14Department of Breast Surgery, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, ChinaDepartment of Breast Surgery, Fuzhou University Affiliated Provincial Hospital, Fuzhou, ChinaDepartment of Breast Surgery, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, ChinaDepartment of Breast Surgery, Fuzhou University Affiliated Provincial Hospital, Fuzhou, ChinaCollege of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, ChinaDepartment of Breast Surgery, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, ChinaDepartment of Breast Surgery, Fuzhou University Affiliated Provincial Hospital, Fuzhou, ChinaDepartment of Breast Surgery, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, ChinaDepartment of Breast Surgery, Fuzhou University Affiliated Provincial Hospital, Fuzhou, ChinaDepartment of Breast Surgery, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, ChinaDepartment of Breast Surgery, Fuzhou University Affiliated Provincial Hospital, Fuzhou, ChinaDepartment of Breast Surgery, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, ChinaDepartment of Breast Surgery, Fuzhou University Affiliated Provincial Hospital, Fuzhou, ChinaDepartment of Breast Surgery, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, ChinaDepartment of Breast Surgery, Fuzhou University Affiliated Provincial Hospital, Fuzhou, ChinaBackground and objectiveWhether sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) for breast cancer is an alternative to axillary lymph node dissection (ALND) remains controversial. In this study, the results of SLNB performed with 99mTc-Rituximab combined with dyes were analyzed, and the application value of the double-tracing method of 99mTc-Rituximab combined with dyes in SLNB after breast cancer NAC was evaluated, the feasibility of SLNB after NAC and the clinical application of the novel tracer 99mTc-Rituximab and its value in internal mammary lymph node(IMLN) was discussed.MethodsA retrospective analysis of 106 breast cancer patients who underwent post-NAC SLNB from August 2019 to August 2023 at Fujian Provincial Hospital, where SLNB was performed using 99mTc-Rituximab combined with dye imaging or dye imaging alone. The detection rate, sensitivity, false-negative rate, accuracy and the detection rate of internal mammary lymph node(IMLN) biopsy were compared between the two tracing methods.Results70 cases were included in the dual-tracer group, with a detection rate of 97.14% (68/70), an average number of detected SLNs of (6.06 ± 5.29), a sensitivity of 92.86% (26/28), a false negative rate of 7.14% (2/28), and an accuracy of 97.14% (68/70). 36 cases were included in the single-tracer group, with a detection rate of 66.67% (24/36), an average number of detected SLNs of (3.17 ± 3.073), a sensitivity of 54.55% (11/22), a false negative rate of 45.45% (10/22), and an accuracy of 72.22% (26/36). There were significant differences in the detection rate and the average number of detected SLNs between the two groups (detection rate: P=0.004; detection number: P=0.038), but there were no significant differences in the sensitivity, accuracy, and false negative rate (P>0.05). A total of 70 patients were examined for internal mammary lymph node biopsy with dual tracer, and 22 patients were detected with an imaging rate of 31.42% (22/70), and a detection rate of 72.72% (16/22).ConclusionsFor patients with breast cancer, the dual-tracer method combining radionuclide and dye for SNLB after neoadjuvant chemotherapy can improve the detection rate of sentinel lymph nodes and reduce the false-negative rate. In the long term, the quality of life of patients can be helped to improve by this approach. Compared with other tracers, 99mTc-Rituximab can improve the detection rate of internal mammary lymph nodes, with the characteristics of rapid clearance of injection site, less secondary lymph node visualization, and hypoallergenicity, which can be used as an ideal tracer for further research.https://www.frontiersin.org/articles/10.3389/fonc.2025.1568550/fullbreast cancerneoadjuvant chemotherapy (NAC)sentinel lymph node biopsy (SLNB)99mTc-Rituximabaxillary lymph node dissection (ALND)
spellingShingle Minxue Zhuang
Minxue Zhuang
Yidan Lin
HongBin Qiu
HongBin Qiu
Wei Chen
Wei Chen
Ruo Wang
Ruo Wang
HuanHong Zeng
HuanHong Zeng
Mengbo Lin
Mengbo Lin
Hui Zhang
Hui Zhang
Clinical study of 99mTc-Rituximab combined with dyes double tracing for axillary sentinel lymph node biopsy after neoadjuvant chemotherapy for breast cancer
Frontiers in Oncology
breast cancer
neoadjuvant chemotherapy (NAC)
sentinel lymph node biopsy (SLNB)
99mTc-Rituximab
axillary lymph node dissection (ALND)
title Clinical study of 99mTc-Rituximab combined with dyes double tracing for axillary sentinel lymph node biopsy after neoadjuvant chemotherapy for breast cancer
title_full Clinical study of 99mTc-Rituximab combined with dyes double tracing for axillary sentinel lymph node biopsy after neoadjuvant chemotherapy for breast cancer
title_fullStr Clinical study of 99mTc-Rituximab combined with dyes double tracing for axillary sentinel lymph node biopsy after neoadjuvant chemotherapy for breast cancer
title_full_unstemmed Clinical study of 99mTc-Rituximab combined with dyes double tracing for axillary sentinel lymph node biopsy after neoadjuvant chemotherapy for breast cancer
title_short Clinical study of 99mTc-Rituximab combined with dyes double tracing for axillary sentinel lymph node biopsy after neoadjuvant chemotherapy for breast cancer
title_sort clinical study of 99mtc rituximab combined with dyes double tracing for axillary sentinel lymph node biopsy after neoadjuvant chemotherapy for breast cancer
topic breast cancer
neoadjuvant chemotherapy (NAC)
sentinel lymph node biopsy (SLNB)
99mTc-Rituximab
axillary lymph node dissection (ALND)
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1568550/full
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