{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T11:21:46Z","timestamp":1785583306214,"version":"3.56.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2017,9,6]],"date-time":"2017-09-06T00:00:00Z","timestamp":1504656000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100007051","name":"Uppsala University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007051","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,10,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Sentinel node biopsy (SNB) using superparamagnetic iron oxide (SPIO) nanoparticles is a novel method in breast cancer. Several studies have verified the non-inferiority of SPIO compared with the standard use of radioisotope 99mTc with or without blue dye. The aim of the MONOS study presented here was to evaluate the use of SPIO as a sole tracer and the efficacy of tracer injection in the preoperative setting.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This prospective cohort study was carried out in two hospitals, one using 99mTc and the other SPIO. 99mTc was injected in the morning of the day of surgery or the day before. SPIO was either injected before surgery in the outpatient clinic or 1 h before the operation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 338 consecutive patients with breast cancer underwent 343 procedures; SPIO nanoparticles were used in 184 procedures and 99mTc-labelled tracer in 159. Detection rates for SPIO and 99mTc were 95\u00b76 and 96\u00b79 per cent respectively (P = 0\u00b7537). All nodes with SPIO uptake were coloured brown. Fewer nodes were retrieved with SPIO (mean 1\u00b735 versus 1\u00b789), regardless of whether blue dye was used (P &amp;lt; 0\u00b7001). Preoperative SPIO injection (58\u00b77 per cent of procedures), a median of 16 (range 2\u201327) days before the procedure, was associated with a better tracer-specific detection rate (95\u00b73 versus 86 per cent; P = 0\u00b7031) and retrieval of more nodes (mean 1\u00b743 versus 1\u00b703; P &amp;lt; 0\u00b7001) than perioperative administration. Skin staining was present in 39\u00b79 per cent of patients, and was related to breast-conserving surgery and periareolar injection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The use of SPIO alone is a safe alternative, with results comparable to those of the standard dual technique using 99mTc and blue dye. The efficacy of injection in the preoperative setting simplifies logistics and improves performance. Skin staining can be prevented by a deeper peritumoral injection.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.10606","type":"journal-article","created":{"date-parts":[[2017,9,6]],"date-time":"2017-09-06T16:25:02Z","timestamp":1504715102000},"page":"1675-1685","source":"Crossref","is-referenced-by-count":70,"title":["Superparamagnetic iron oxide nanoparticles as the sole method for sentinel node biopsy detection in patients with breast cancer"],"prefix":"10.1093","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3622-3575","authenticated-orcid":false,"given":"A","family":"Karakatsanis","sequence":"first","affiliation":[{"name":"Department of Surgical Sciences, Uppsala University Hospital, Uppsala Academic Hospital, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Daskalakis","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Uppsala University Hospital, Uppsala Academic Hospital, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"St\u00e5lberg","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Uppsala University Hospital, Uppsala Academic Hospital, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Olofsson","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, Uppsala University Hospital, Uppsala Academic Hospital, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y","family":"Andersson","sequence":"additional","affiliation":[{"name":"Department of Surgery, V\u00e4stmanlands County Hospital, V\u00e4ster\u00e5s, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Eriksson","sequence":"additional","affiliation":[{"name":"Department of Surgery, V\u00e4stmanlands County Hospital, V\u00e4ster\u00e5s, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Bergkvist","sequence":"additional","affiliation":[{"name":"Centre for Clinical Research, Uppsala University, Uppsala, Sweden"},{"name":"Department of Surgery, V\u00e4stmanlands County Hospital, V\u00e4ster\u00e5s, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"W\u00e4rnberg","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Uppsala University Hospital, Uppsala Academic Hospital, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,9,6]]},"reference":[{"key":"2021020617165815800_bjs10606-bib-0001","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1093\/jnci\/djj158","article-title":"Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC trial","volume":"98","author":"Mansel","year":"2006","journal-title":"J Natl Cancer Inst"},{"key":"2021020617165815800_bjs10606-bib-0002","doi-asserted-by":"crossref","first-page":"1854","DOI":"10.1245\/s10434-010-0945-z","article-title":"Sentinel node identification rate and nodal involvement in the EORTC 10981-22023 AMAROS trial","volume":"17","author":"Straver","year":"2010","journal-title":"Ann Surg Oncol"},{"key":"2021020617165815800_bjs10606-bib-0003","doi-asserted-by":"crossref","first-page":"2239","DOI":"10.1007\/s00268-012-1623-z","article-title":"The false-negative rate of sentinel node biopsy in patients with breast cancer: a meta-analysis","volume":"36","author":"Pesek","year":"2012","journal-title":"World J Surg"},{"key":"2021020617165815800_bjs10606-bib-0004","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1016\/j.ejso.2012.04.016","article-title":"Axillary recurrences after sentinel lymph node biopsy: a multicentre analysis and follow-up of sentinel lymph node negative breast cancer patients","volume":"38","author":"van Wely","year":"2012","journal-title":"Eur J Surg Oncol"},{"key":"2021020617165815800_bjs10606-bib-0005","doi-asserted-by":"crossref","first-page":"e351","DOI":"10.1016\/S1470-2045(13)70590-4","article-title":"Novel techniques for sentinel lymph node biopsy in breast cancer: a systematic review","volume":"15","author":"Ahmed","year":"2014","journal-title":"Lancet Oncol"},{"key":"2021020617165815800_bjs10606-bib-0006","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.ejso.2010.12.007","article-title":"Sentinel lymph node biopsy in early breast cancer surgery \u2013 working with the risks of vital blue dye to reap the benefits","volume":"37","author":"White","year":"2011","journal-title":"Eur J Surg Oncol"},{"key":"2021020617165815800_bjs10606-bib-0007","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1245\/s10434-013-3379-6","article-title":"SentiMAG Trialists Group. 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