Sentinel node biopsy in patients with breast cancer - evaluation of exposure to radiation of medical staff

Aim: To measure the absorbed doses of radiation to hands of medical staff performing sentinel node biopsy in breast cancer patients. Methods: The study was conducted in 2004, during sentinel node biopsies in 13 breast cancer patients (T1/T2N0). Sentinel nodes were identified with the use of combined radiotracer/blue dye technique (lymphoscintigraphy-Tc-99m on albumin carrier, surgery after 24 h; blue dye: intraoperative detection of gamma radiation). Highly sensitive thermoluminescent dosimeters (TLD) made of LiF were used to assess the absorbed doses of radiation during the procedure. During lymphoscintigraphy and during Surgical procedure a total of 57 TLDs was placed on different parts of hands of medical staff. Results: Maximal dose recorded during lymphoscintigraphy by TLDs placed on the hands of the physician injecting the radiotracer was 164 mu Sv. Mean recorded doses were higher for non-dominant hand, especially for distal parts of the index finger, third finger and thumb. During the surgical procedure, TLDs placed on the hands of medical staff recorded much lower doses of radiation than during lymphoscintigraphy. The highest dose was recorded by TLD placed on the pulp of the dominant hand index finger (22 mu Sv) of the operating surgeon. Mean doses recorded by TLDs placed on the hands of the operating Surgeon ranged from 2 to 8 tSv. The absorbed dose of radiation to hands of the scrub nurse was similar to that absorbed to hands of the operating surgeon. Conclusion: The maximum recorded dose during sentinel node biopsy in this study was 2200 times smaller than current 1-year dose limit. (c) 2005 Elsevier Ltd. All rights reserved.