ID 123730

USE OF RADIOACTIVE IODINE (I125) SEED FOR

THE LOCALIZATION OF AXILLARY LYMPH
NODES IN BREAST CANCER PATIENTS
Anschau JKP¹; Krumenauerr KM¹; Pizaia R¹; Lourenço RAMC¹; Costa MM2;
Oliveira MVFT3; Fonseca LMB4; Júnior RRM4; Franca CAS4; Penna ABRC5.
¹Acadêmico IDOMED - Angra dos Reis/RJ, ² Hospital Universitário
Clementino Fraga Filho – Rio de Janeiro, 3LBG Celular Diagnóstico,
4
Docente IDOMED – Angra dos Reis/RJ, 5 A.B.R.C. - Radioterapia Ingá
E-mail para contato: jeniferkpa@gmail.com

INTRODUCTION: Therapies against breast cancer are diverse. Neoadjuvant

chemotherapy is an example used as a tool to decrease the tumor stage, improve
breast conservation therapy, and reduce the stage of axillary lymph nodes. Routine
axillary lymph node dissection is increasingly being considered overtreatment in women
where a complete pathological axillary response is obtained. As an alternative, axillary
lymph node marking with low-dose I125 seeds is being used, known as a minimally
invasive method to assess the pathological response of lymph node metastases after
neoadjuvant systemic treatment in patients with breast cancer. The seeds help with the
precision of the lesion territory, where they are located by a probe capable of
highlighting the emitted gamma radiation. Therefore, it is possible to reduce the amount
of dissected normal tissue, minimizing risks, and avoiding unwanted aesthetic
alterations.

OBJECTIVE: The present study assessed the feasibility of marking clinically suspected
enlarged axillary nodes with I125 seeds before neoadjuvant chemotherapy, facilitating
their identification and surgical excision after neoadjuvant treatment.

METHODS: A retrospective analysis was conducted on breast cancer patients who

underwent marking of clinically positive axillary lymph nodes with I125 before receiving
neoadjuvant chemotherapy. The gamma-probe was used to guide the excision of the
marked lymph node, ensuring the removal of the correct lymph node by detecting the
I125 source within it and confirming the absence of radiation in the rest of the axilla.
The study was approved by the research ethics committee (CAEE
47149315.4.0000.5533).

RESULTS: The study included a total of nine patients with clinically node-positive
disease. The mean age was 60 years (95% CI 57.4 - 62.7 / SD ± 10.0), and all patients
had invasive ductal carcinoma. The axillary lymph node marking procedure using I125
seeds was successfully performed in all cases, with no major complications reported.
The marked axillary lymph nodes facilitated accurate identification and dissection
during subsequent surgery, as the I125 seeds were found within the lymph node in all
patients.

CONCLUSION: This single-institution experience demonstrates the successful use of

I125 for axillary lymph node marking in breast cancer patients, facilitating its surgical
removal.

REFERENCES: 1- Axillary Staging After Neoadjuvant Chemotherapy for Breast Cancer: A Pilot Study
Combining Sentinel Lymph Node Biopsywith Radioactive Seed Localization of Pre-treatment Positive Axillary
Lymph Nodes.
2- A Novel Less-invasive Approach for Axillary Staging After Neoadjuvant Chemotherapy in Patients With
Axillary Node-positive Breast Cancer by Combining Radioactive Iodine Seed Localization in the Axilla With the
Sentinel Node Procedure (RISAS): A Dutch Prospective Multicenter Validation Study
3- Marking Axillary Lymph Nodes With Radioactive Iodine Seeds for Axillary Staging After Neoadjuvant
Systemic Treatment in Breast Cancer Patient.
4- Radioactive Iodine-125 in Tumor Therapy: Advances and Future Directions
5- Radioactive Seed Localization for Conservative Surgery of Nonpalpable Breast Cancer: Recommendations for
Technology Implantation Program