Abstract
BACKGROUND: Sentinel lymph node biopsy after technetium-99 (Tc(99)) localization is a mainstay of oncologic breast surgery. The timing of Tc(99) injection can complicate operating room schedules, which can cause increasing overall costs of care and patient discomfort. METHODS: This study compared 59 patients who underwent breast cancer surgery including sentinel lymph node biopsy. Based on the surgeon's choice, 29 patients were treated with Tc(99), and 30 patients received the iron-based tracer, Magtrace. The primary outcomes were time spent on the care pathway and operating time from commissioning of the probe to removal of the sentinel node. The secondary outcomes were patient pain levels and reimbursement. RESULTS: The mean time spent on the preoperative breast cancer care pathway was significantly shorter for the Magtrace group (5.4 ± 1.3 min) than for the Tc(99) group (82 ± 20 min) (p < 0.0001). The median time from probe usage to sentinel node extirpation was slightly but not significantly shorter in the Magtrace group (5 min; interquartile range [IQR], 3-15 min vs 10 min; IQR, 7-15 min; p = 0.151). Reimbursement and pain levels remained unchanged, and the hospital length of stay was similar in the two groups (Magtrace: 5.1 ± 2.3 days vs Tc(99): 4.5 ± 3.2 days). CONCLUSIONS: Magtrace localization shortened the preoperative care pathway and did not affect surgical time or reimbursement. Once established, it could allow for cost reduction and improve patient comfort.