Evidence map›Paper›PMID 40698872›Full record

ArticleThe British journal of surgery2025

Ultra-low dose superparamagnetic iron oxide nanoparticle injection for sentinel lymph node detection in breast cancer: prospective cohort study.

Lovisa Sundh, Marya Alzoubi, Nizar Abu-Oddos, Sarah Båtelsson, Per Nyman, Andreas Karakatsanis, Staffan Eriksson, Mookaiah Ravichandran, Kian Chin, Roger Olofsson Bagge and 2 more

Abstract readMulticenter StudyComparative Study
In one paragraph

Article in The British journal of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Lovisa SundhDepartment of Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Marya AlzoubiDepartment of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Nizar Abu-OddosDepartment of Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Sarah BåtelssonSection for Breast Surgery, Department of Surgery, Västmanland County Hospital, Västerås, Sweden.
Per NymanDepartment of Surgery, Skaraborg Hospital, Lidköping, Sweden.
Andreas KarakatsanisSection for Breast Surgery, Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden.ORCID 0000-0003-3622-3575
Staffan ErikssonSection for Breast Surgery, Department of Surgery, Västmanland County Hospital, Västerås, Sweden.
Mookaiah RavichandranDepartment of Surgery, Skaraborg Hospital, Lidköping, Sweden.
Kian ChinDepartment of Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Roger Olofsson BaggeDepartment of Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Nushin MirzaeiDepartment of Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Fredrik WärnbergDepartment of Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.ORCID 0000-0002-0130-7296

Funding

Region Västra GötalandSwedish Breast Cancer Society ALFGBG-965050Swedish state and seven Swedish
6 · The paper itself

Abstract

backgroundSentinel lymph node (SLN) staging is essential in breast cancer. Superparamagnetic iron oxide nanoparticles (SPIO) is a tracer where the optimal injection technique is yet not defined. The aim was to evaluate SLN detection using 0.1 ml SPIO intradermally compared to technetium-99 m (Tc99) ± blue dye.

methodPatients planned for breast surgery and SLN biopsy received 0.1 ml SPIO intradermally at the areolar border or over the tumour. Tc99 ± blue dye was administered per clinical routine. Magnetic, radioactive, or blue nodes were removed and analysed separately. SLN detection and numbers, concordance, and skin discoloration were analysed.

resultsA total of 216 patients were included at five hospitals. Median age was 63 years, tumour size 15.9 mm, and 91.7% underwent breast conservation. SPIO was injected a median of 12 days before surgery. SLN detection was 211/216 (97.7%; 95% c.i.: 94.7 to 99.2) and 215/216 (99.5%; 95% c.i.: 98.6 to 100.0) for SPIO and Tc99 ± blue dye (P = 0.111) respectively. In total, 403 SLNs were removed; 341 detected by SPIO and 349 by Tc99 ± blue dye. The median number of SLNs was 1 (iqr: 1-2) for both tracer methods. Among 46 SLN-positive patients, 42 were correctly staged with both tracers, two with SPIO only and two with Tc99 ± blue dye only. Skin discoloration was evaluated in 107 patients. The median discoloured area was 0 cm2 (iqr: 0-0.7) among 49 patients with the injection site surgically removed and 1.3 cm2 (iqr: 0.6-2.8) among 58 without removal.

conclusionAn ultra-low dose of 0.1 ml intradermal injection of SPIO was non-inferior to Tc99 ± blue dye for SLN detection. Skin discoloration was limited and further reduced by removal during surgery.

Indexed as

Breast NeoplasmsContrast MediaMagnetic Iron Oxide NanoparticlesMagnetite NanoparticlesSentinel Lymph NodeSentinel Lymph Node BiopsyAdultAgedAged, 80 and overColoring AgentsFemaleHumansInjections, IntradermalLymphatic MetastasisMiddle AgedProspective StudiesColoring AgentsContrast MediaMagnetite NanoparticlesTechnetiumTechnetium-99

Identifiers

PMID40698872
PMCPMC12284759

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.