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New Radiation-Free Protocol Streamlines Staging for Breast Cancer Biopsies

February 03, 2023

Breast surgeons and surgical oncologists at Orlando Health Cancer Institute are implementing an innovative surgical approach that offers breast cancer patients the most advanced modality for mapping sentinel lymph nodes. The surgical team recently evaluated MagTrace®, a liquid magnetic tracer that enables surgeons to perform radiation-free sentinel lymph node identification and biopsy to better detect spread of disease and more accurately define risk of recurrence and appropriate treatment. The resulting data and positive outcomes supported a systemwide rollout.

Terry P. Mamounas, MD

MagTrace brown dye is infused with superparamagnetic iron oxide (SPIO) developed specifically for sentinel node biopsies. Once injected, these magnetic particles follow the same lymphatic path as a spreading cancer cell. Using a specialized probe, surgeons can track MagTrace to the first draining lymph nodes possibly containing cancer to verify if the disease has spread. MagTrace has rapid integration and can be injected into the breast tissue up to 20 minutes before surgery.

“This technology allows our breast surgeons to map the lymphatic vessels and identify sentinel nodes in the operating room rather than having to rely on radioactive isotope injections the day before or the morning of surgery,” says Terry P. Mamounas, MD, MPH, medical director, Comprehensive Breast Program at Orlando Health Cancer Institute. “MagTrace saves patients from a nuclear medicine procedure and provides more efficiency for surgical planning.”

Unlike prior axillary lymph node dissections, which included removal of 15 to 20 lymph nodes, the sentinel lymph node mapping and removal usually requires removing around 2 to 3 sentinel lymph nodes. Compared to axillary lymph node dissection, sentinel lymph node biopsy reduces postoperative pain and numbness, improves shoulder motion and decreases the risk of arm swelling (lymphedema).

“Sentinel lymph node biopsy provides prognostic information on the pathologic status of the axillary nodes without having to remove a large number of them,” says Dr. Mamounas, investigator of several grants from the National Cancer Institute. He oversaw the MagTrace evaluation at Orlando Health Orlando Regional Medical Center and is directing its implementation systemwide.

As part of a high-volume institute with an integrated, multidisciplinary team of specialists, the nationally accredited Breast Care Center offers patients the latest diagnostic tools, treatments and surgical approaches.

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