[Development of technologies for sentinel lymph node biopsy in case of breast cancer]

Sentinel lymph node (SLN) biopsy is now routinely used in breast cancer multidisciplinary management. The combined use of blue dye and lymphoscintigraphy gives the best SLN identification rate. Two different types of probes are available for the SLN procedure: semi-conductor probes and scintillator ones. Moreover, to increase the performances of the SLN procedure, intra-operative gamma cameras have recently been developed. The objectives of our review are to describe these materials to highlight their advantages and drawbacks from the point of view of the surgeon and the physicist.

Performances of a new prototype handheld scintillating probe for the search of sentinel lymph nodes in breast cancer

AIM

The aim of this study is to evaluate the performances of a new prototype handheld gamma probe in a series of patients with infiltrative breast cancer justifying sentinel lymph node (SLN) excision.

METHODS AND PATIENTS

SLN excision was performed on nine patients being treated for infiltrative breast cancer. After preoperative radio-isotope injection and lymphoscintigraphy, individual removal of all radioactive nodes was performed after their localisation using a novel new prototype handheld gamma intraoperative probe named CarolIReS. The activity of SLN following resection has been measured by a gamma ray counter. The mean geometrical detection efficiency of this gamma ray counter has been obtained by Monte Carlo simulation.

RESULTS

With respect to the total number of SLNs identified by the CarolIReS probe, the detection probability was 80% for the lymphoscintigraphy. A mean number of 2.2 (1-5) SLNs per patient was detected after the complete SLN procedure. Among the removed SLNs, 19 were axillary SLN, 17 were located in the level I of Berg, two were located in the Rotter area and one was an intramammary SLN (ISLN) located in the lower inner area of the breast. The detection efficiency of the CarolIReS probe ranged from 2.1 to 100.0cpskBq(-1) referred to the activity of the SLN at the time of the surgery.

CONCLUSION

This study shows that the CarolIReS probe is well adapted to the SLN detection and allows an efficient identification of both axillary and intramammary lymph nodes.

Halo structure of (14)Be

The two-neutron halo nucleus (14)Be has been investigated in a kinematically complete measurement of the fragments ((12)Be and neutrons) produced in dissociation at 35 MeV/nucleon on C and Pb targets. Two-neutron removal cross sections, neutron angular distributions, and invariant mass spectra were measured, and the contributions from electromagnetic dissociation (EMD) were deduced. Comparison with three-body model calculations suggests that the halo wave function contains a large nu(2s(1/2))(2) admixture. The EMD invariant mass spectrum exhibited enhanced strength near threshold consistent with a nonresonant soft-dipole excitation.