Skip to main content
SpringerLink
Log in

Safety guidelines for radiolocalised sentinel node resection

  • Original Paper
  • Published:
Irish Journal of Medical Science Aims and scope Submit manuscript

Abstract

Background

Sentinel node radiolocalisation procedures are associated with low levels of radiation exposure. Radioactive material is present in the operating theatre and pathology laboratory. In most hospitals there are no official regulations in place for sentinel node radiation exposure.

Aim

To establish guidelines on the safety of sentinel node mapping with emphasis on the management of radioisotopes.

Methods

The current literature regarding sentinel node procedures and radiation safety was reviewed. EU and US radiation safety regulations were scrutinised.

Results

Personnel involved in sentinel node procedures are exposed to low levels of radiation. These levels are not high enough to require designated radiation workers in the theatre and pathology laboratory. Awareness of radiation safety and certain precautions during the procedure and processing of the specimen can further reduce levels of exposure.

Conclusion

Although low levels of radiation exposure are associated with sentinel node procedures, awareness of radiation safety and adherence to regulations, along with close interdepartmental co-operation, are recommended for further reduction in radiation exposure and safe application of this technique.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Reintgen D, Balch CM, Kirkwood J, Ross M. Recent advances in the care of the patient with malignant melanoma.Ann Surg 1997; 225: 1–14.

    Article  CAS  PubMed  Google Scholar 

  2. Cochran AJ. Surgical Pathology Remains Pivotal in the Evaluation of “Sentinel” Lymph Nodes. (Editorial)Am J Surg Path 1999; 23: 1169–72.

    Article  CAS  PubMed  Google Scholar 

  3. Borgstein PJ, Pijpers R, Comans EF et al. Sentinel lymph node biopsy in breast cancer: guidelines and pitfalls of lymphoscintography and gamma probe detection.J Am Coll Surg 1998; 186: 275–83.

    Article  CAS  PubMed  Google Scholar 

  4. Morton DL, Wen D-R, Wong JH et al. Technical details of intraoperative lymphatic mapping for early stage melanoma.Arch Surg 1992; 127: 392–9.

    CAS  PubMed  Google Scholar 

  5. Schachter J, Laish A, Mekhmandarov S et al. Standard and non standard applications of sentinel node-guided melanoma surgery.World J Surg 2000; 24: 491–5.

    Article  CAS  PubMed  Google Scholar 

  6. Eary JF, Mankoff DA, Dunnwald LK et al. Sentinel lymph node mapping for breast cancer: analysis in a diverse patient group.Radiology 1999; 213: 526–9.

    CAS  PubMed  Google Scholar 

  7. O’Hea BJ, Hill ADK, El-Shirbiny AM et al. Sentinel lymph node biopsy in breast cancer: Initial experience at Memorial Sloan-Kettering Cancer Center.J Am Coll Surg 1998; 186: 423–7.

    Article  PubMed  Google Scholar 

  8. Krag D, Weaver D, Ashikaga T et al. The sentinel lymph node in breast cancer. A multicentre validation study.New Engl J Med 1998; 339: 941–6.

    Article  CAS  PubMed  Google Scholar 

  9. Veronesi U, Paganelli G, Viale G et al. Sentinel lymph node and axillary disecrion in breast cancer: Results in a large series.J Natl Cancer Iust 1999; 91: 368–73.

    Article  CAS  Google Scholar 

  10. Fitzgibbons PL, LiVolsi VA. The Surgical Pathology Committee of the College of American Pathologists, Association of Directors of Anatomic and Surgical Pathology.

  11. Recommendations for Handling Radioactive Specimens Obtained by Sentinel Lymphadenectomy.Am J Surg Pathol 2000; 24: 1549–51.

    Google Scholar 

  12. Stratmann SL, McCarthy TM, Kuhn JA. Radiation safety with breast sentinel node biopsy.Am J Surg 1999; 178: 454–7.

    Article  CAS  PubMed  Google Scholar 

  13. Glass EC, Basinski JE, Krasne DL, Guiliano AE. Radiation Safety Considerations for Sentinel Node Techniques. (Editorial)Ann Surg Oncol 1999; 6: 10–1.

    Article  CAS  PubMed  Google Scholar 

  14. Title 10. Code of Federal Regulations. Units of Radiation Dose. 10CFR20.1004. Washington DC: Government Printing Office 2000.

  15. Title 10. Code of Federal Regulations. Units of Radioactivity. 10CFR20.1005. Washington DC: Government Printing Office 2000.

  16. SI 125 of 2000. Radiological Protection act, 1991, (Ionising Radiation) Order, 2000. Government Publishing Office, Molesworth Street, Dublin 2.

  17. Publication 60. 1990 Recommendations of the International Commission on Radiological Protection.Annals of IRCP 1991; 21: 1–3.

    Google Scholar 

  18. Title 10. Code of Federal Regulations. Occupational Dose Limits for Adults. 10CFR20.1201. Washington DC: Government Printing Office 2000.

  19. Title 10. Code of Federal Regulations. Dose Limits for Individual Members of the Public. 10CFR20.1301. Washington DC: Government Printing Office 2000.

  20. Title 10. Code of Federal Regulations. Dose Equivalent to an Embryo/Fetus. 10CFR20.1208. Washington DC: Government Printing Office 2000.

  21. Title 49. Code of Federal Regulations. Radiation Protection Program. 49CFR172.803. Washington DC: Government Printing Office 1996.

  22. Title 10. Code of Federal Regulations. ALARA Program. 10.CFR.35.20. Washington DC: Government Printing Office 2000.

  23. Kestgar MRS, Waddington WA, Lakhari SK, Ell PJ. Dosimetry and Radiation Protection. In: The Sentinel Node in Surgical Oncology. Springer-Verlag, Berlin Heidelberg, 1999, pp. 91–101.

    Google Scholar 

  24. Miner TS, Shriver CD, Flicek PR et al. Guidelines for the safe use of radioactive materials during localization and resection of the sentinel lymph node.Ann Surg Oncol 1999; 6: 75–82.

    Article  CAS  PubMed  Google Scholar 

  25. Title 10. Code of Federal Regulations. Decay In Storage. 10CFR35.92. Washington DC: Government Printing Office 2000.

  26. Title 10. Code of Federal Regulations. Disposal of Specific Wastes. 10CFR20.2005. Washington DC: Government Printing Office 2000.

  27. Title 10. Code of Federal Regulations. Possession, Use, Calibration and Check of Dose Calibrators. 10.CFR.35.50. Washington DC: Government Printing Office 2000.

  28. Title 10. Code of Federal Regulations. Calibration and Check of Survey Instruments. 10.CFR.35.51. Washington DC: Government Printing Office 2000.

Download references

Author information

Authors and Affiliations

  1. University Departments of Surgery, Clinical Engineering and Physics, St Vincent’s University Hospital, Dublin, Ireland

    M. Casey

  2. University Departments of Surgery, and Radiology, St Vincent’s University Hospital, Dublin, Ireland

    C. D. Collins

  3. St Vincent’s University Hospital, Dublin, Ireland

    N. Nugent, A. D. K. Hill, L. Kelly, B. Dijkstra, E. W. McDermott & N. O’Higgins

Authors
  1. N. Nugent
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. D. K. Hill
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Casey
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. L. Kelly
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B. Dijkstra
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. C. D. Collins
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. E. W. McDermott
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. N. O’Higgins
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. D. K. Hill.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nugent, N., Hill, A.D.K., Casey, M. et al. Safety guidelines for radiolocalised sentinel node resection. Ir J Med Sci 170, 236–238 (2001). https://doi.org/10.1007/BF03167786

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03167786

Keywords

Search

Navigation