Skip to main content
PMC home page
British Journal of Cancer logoLink to British Journal of Cancer
. 1989 Feb;59(2):296–302. doi: 10.1038/bjc.1989.61

The detection of axillary lymph node metastases from breast cancer by radiolabelled monoclonal antibodies: a prospective study.

J J Tjandra 1, N P Sacks 1, C H Thompson 1, M J Leyden 1, S A Stacker 1, M Lichtenstein 1, I S Russell 1, J P Collins 1, J T Andrews 1, G A Pietersz 1, et al.
PMCID: PMC2247001  PMID: 2930695

Abstract

In a prospective study to assess the accuracy of monoclonal immunoscintigraphy for the detection of axillary lymph node metastases in breast cancer, two murine monoclonal antibodies that react with human breast cancer (3E1.2 and RCC-1) were labelled with 131iodine, and the radiolabelled antibody was injected subcutaneously into the interdigital spaces of both hands of 40 patients, 36 of whom had breast cancer and the remaining four of whom had fibroadenoma (the normal, contralateral axilla was used as a control). Of the patients with breast cancer, the findings from the scintigraphy images were correlated with histopathology or cytology of the axillary lymph nodes; images were regarded as positive and hence indicative of lymph node metastases if the amount of background-subtracted radioactive count in axilla on the side of breast cancer exceeded the contralateral normal side by a ratio greater than or equal to 1.5:1.0 as assessed by computer analysis. Using this method, immunoscintigraphy had an overall sensitivity of 33% (23% with 131I-3E1.2 and 50% with 131I-RCC-1) for the detection of lymph node metastases and a specificity of 63% (67% with 131I-3E1.2 and 60% with 131I-RCC-1) with problems of non-specific uptake by presumably normal lymph nodes. The results of immunoscintigraphy obtained with 131I-RCC-1 (IgG) were superior to 131I-3E1.2 (IgM) although the accuracy of immunoscintigraphy using 131I-RCC-1 (56%) was not much better than preoperative clinical assessment (50%). However, there were cases when immunoscintigraphy using radiolabelled antibody (IgM or IgG) detected axillary lymph node metastases not suspected by clinical examination. Thus it appears that while immunoscintigraphy may be a useful adjunct to preoperative clinical assessment and is simple and safe, a major improvement in its accuracy is needed before it can replace axillary dissection and histological examination in the accurate staging of axilla in breast cancer.

Full text

PDF
302

Images in this article

299Figure 1
on p.299
299Figure 2
on p.299
300Figure 3
on p.300
300Figure 4
on p.300

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Armitage N. C., Perkins A. C., Pimm M. V., Farrands P. A., Baldwin R. W., Hardcastle J. D. The localization of an anti-tumour monoclonal antibody (791T/36) in gastrointestinal tumours. Br J Surg. 1984 Jun;71(6):407–412. doi: 10.1002/bjs.1800710602. [DOI] [PubMed] [Google Scholar]
  2. Bergqvist L., Strand S. E., Persson B. R. Particle sizing and biokinetics of interstitial lymphoscintigraphic agents. Semin Nucl Med. 1983 Jan;13(1):9–19. doi: 10.1016/s0001-2998(83)80031-2. [DOI] [PubMed] [Google Scholar]
  3. Bunn P. A., Jr, Carrasquillo J. A., Keenan A. M., Schroff R. W., Foon K. A., Hsu S. M., Gazdar A. F., Reynolds J. C., Perentesis P., Larson S. M. Imaging of T-cell lymphoma by radiolabelled monoclonal antibody. Lancet. 1984 Nov 24;2(8413):1219–1221. doi: 10.1016/s0140-6736(84)92781-8. [DOI] [PubMed] [Google Scholar]
  4. Epenetos A. A. Antibody guided lymphangiography in the staging of cervical cancer. Br J Cancer. 1985 Jun;51(6):805–808. doi: 10.1038/bjc.1985.125. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. GREENWOOD F. C., HUNTER W. M., GLOVER J. S. THE PREPARATION OF I-131-LABELLED HUMAN GROWTH HORMONE OF HIGH SPECIFIC RADIOACTIVITY. Biochem J. 1963 Oct;89:114–123. doi: 10.1042/bj0890114. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Gasparini M., Andreoli C., Rodari A., Costa A., Buraggi G. L. Lack of efficacy of lymphoscintigraphy in detecting axillary lymph node metastases from breast cancer. Eur J Cancer Clin Oncol. 1987 May;23(5):475–480. doi: 10.1016/0277-5379(87)90306-3. [DOI] [PubMed] [Google Scholar]
  7. Kim E. E., Corgan R. L., Casper S., Primus F. J., Spremulli E., Estes N., Goldenberg D. M. Axillary lymphoscintigraphy by radioimmunodetection of carcinoembryonic antigen in breast cancer. J Nucl Med. 1979 Dec;20(12):1243–1250. [PubMed] [Google Scholar]
  8. Leak L. V. Studies on the permeability of lymphatic capillaries. J Cell Biol. 1971 Aug;50(2):300–323. doi: 10.1083/jcb.50.2.300. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Leyden M. J., Thompson C. H., Lichtenstein M., Andrews J. T., Sullivan J. R., Zalcberg J. R., McKenzie I. F. Visualization of metastases from colon carcinoma using an iodine 131-radiolabeled monoclonal antibody. Cancer. 1986 Mar 15;57(6):1135–1139. doi: 10.1002/1097-0142(19860315)57:6<1135::aid-cncr2820570613>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
  10. Markwell M. A. A new solid-state reagent to iodinate proteins. I. Conditions for the efficient labeling of antiserum. Anal Biochem. 1982 Sep 15;125(2):427–432. doi: 10.1016/0003-2697(82)90025-2. [DOI] [PubMed] [Google Scholar]
  11. Nelp W. B., Eary J. F., Jones R. F., Hellstrom K. E., Hellstrom I., Beaumier P. L., Krohn K. A. Preliminary studies of monoclonal antibody lymphoscintigraphy in malignant melanoma. J Nucl Med. 1987 Jan;28(1):34–41. [PubMed] [Google Scholar]
  12. Parish C. R., McKenzie I. F. A sensitive rosetting method for detecting subpopulations of lymphocytes which react with alloantisera. J Immunol Methods. 1978;20:173–183. doi: 10.1016/0022-1759(78)90254-5. [DOI] [PubMed] [Google Scholar]
  13. Rainsbury R. M. The localization of human breast carcinomas by radiolabelled monoclonal antibodies. Br J Surg. 1984 Oct;71(10):805–812. doi: 10.1002/bjs.1800711023. [DOI] [PubMed] [Google Scholar]
  14. Rockoff S. D., Goodenough D. J., McIntire K. R. Theoretical limitations in the immunodiagnostic imaging of cancer with computed tomography and nuclear scanning. Cancer Res. 1980 Aug;40(8 Pt 2):3054–3058. [PubMed] [Google Scholar]
  15. Schroff R. W., Foon K. A., Beatty S. M., Oldham R. K., Morgan A. C., Jr Human anti-murine immunoglobulin responses in patients receiving monoclonal antibody therapy. Cancer Res. 1985 Feb;45(2):879–885. [PubMed] [Google Scholar]
  16. Smedley H. M., Finan P., Lennox E. S., Ritson A., Takei F., Wraight P., Sikora K. Localisation of metastatic carcinoma by a radiolabelled monoclonal antibody. Br J Cancer. 1983 Feb;47(2):253–259. doi: 10.1038/bjc.1983.33. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Stacker S. A., Thompson C., Riglar C., McKenzie I. F. A new breast carcinoma antigen defined by a monoclonal antibody. J Natl Cancer Inst. 1985 Nov;75(5):801–811. doi: 10.1093/jnci/75.5.801. [DOI] [PubMed] [Google Scholar]
  18. Thompson C. H., Jones S. L., Whitehead R. H., McKenzie I. F. A human breast tissue-associated antigen detected by a monoclonal antibody. J Natl Cancer Inst. 1983 Mar;70(3):409–419. [PubMed] [Google Scholar]
  19. Thompson C. H., Lichtenstein M., Stacker S. A., Leyden M. J., Salehi N., Andrews J. T., McKenzie I. F. Immunoscintigraphy for detection of lymph node metastases from breast cancer. Lancet. 1984 Dec 1;2(8414):1245–1247. doi: 10.1016/s0140-6736(84)92798-3. [DOI] [PubMed] [Google Scholar]
  20. Tjandra J. J., Busmanis I., Russell I. S., Collins J. P., Reed R. G., McKenzie I. F. The association of mammary serum antigen (MSA) with the histopathological findings in localised breast cancer. Br J Cancer. 1988 Dec;58(6):815–817. doi: 10.1038/bjc.1988.316. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Weinstein J. N., Steller M. A., Covell D. G., Holton O. D., 3rd, Keenan A. M., Sieber S. M., Parker R. J. Monoclonal antitumor antibodies in the lymphatics. Cancer Treat Rep. 1984 Jan;68(1):257–264. [PubMed] [Google Scholar]
  22. Weinstein J. N., Steller M. A., Keenan A. M., Covell D. G., Key M. E., Sieber S. M., Oldham R. K., Hwang K. M., Parker R. J. Monoclonal antibodies in the lymphatics: selective delivery to lymph node metastases of a solid tumor. Science. 1983 Oct 28;222(4622):423–426. doi: 10.1126/science.6623082. [DOI] [PubMed] [Google Scholar]
  23. Williams M. R., Perkins A. C., Campbell F. C., Pimm M. V., Hardy J. G., Wastie M. L., Blamey R. W., Baldwin R. W. The use of monoclonal antibody 791T/36 in the immunoscintigraphy of primary and metastatic carcinoma of the breast. Clin Oncol. 1984 Dec;10(4):375–381. [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES