Immunolymphscintigraphy with BCD-F9 Monoclonal Antibody and Its F(ab’)2 Fragments for the Preoperative Staging of Breast Cancers
In breast cancer, assessment of axillary lymph node status is the most important prognostic factor for accurate staging, management and follow-up of patients with primary tumors. Several studies suggest that preoperative staging with techniques as direct breast lymphography, ultrasound and CT-scan often fail to identify the extent of the metastatic involvement in the axilla. To this end, we have developed a novel, simple, non-invasive and reliable immunolymphscintigraphic(ILS) technique that allows the accurate preoperative diagnosis of lymph node metastasis in patients with early stages of breast cancer1–4. In this article, we report on a consecutive series of thirty-nine breast cancer patients undergoing preoperative staging by ILS using the BCD-F9 monoclonal antibody or its F(ab’)2 fragments. Each patient received 1 mg of a purified preparation containing 1 mCi of Iodine-123, by a subcutaneous injection into the fingerwebs between the 2nd and 3rd finger of both hands. Scans obtained 4, 8 and 12 hours after injection demonstrated adequate tumor accumulation of radiolabeled antibody and accurate tumor visualisation without any background substraction. ILS results were always compared to the histopathological staging. When intact immunoglobulin molecules were injected, 10 out of 11 patients with breast cancer were true positives and 19 out of 21 were true negatives. For the F(ab’)2 fragments, ILS results were positive in 3 out of 3 patients with metastatic cancer and negative in 3 out of 4 patients without metastatic involvement of the axilla. Most importantly to our study, all of the 12 patients with benign breast disease studied showed no positive imaging.
KeywordsTrue Negative Preoperative Staging Benign Breast Disease Axillary Lymph Node Metastasis Axillary Lymph Node Status
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