Abstract
PurposeTechnetium Tc-99m sulfur colloid (99mTc-SC) breast lymphoscintigraphy is commonly performed to identify the sentinel lymph node (SLN) in patients diagnosed with breast carcinoma undergoing lumpectomy. The purpose of this report is to describe how the use of 2% topical lidocaine jelly immediately after the completion of needle localization and prior to scintigraphy may substantially reduce pain associated with the injection of 99mTc-SC.Materials and methodsThis was a quality improvement project. Patients were asked to score the severity of pain associated with the periareolar 99mTc-SC injections for sentinel node lymphoscintigraphy. In order to decrease the discomfort, topical lidocaine was applied to the periareolar skin after the completion of the needle localization, but prior to transferring the patient from the mammography room to the nuclear medicine department for the 99mTc-SC injections. At the time of 99mTc-SC injection, patients were asked to score the pain of injection from 0 (none) to 10 (worst).ResultsThe average pain score of the women who did not receive topical lidocaine jelly was 8 (range: 5-9). In the 10 women who received topical lidocaine jelly after needle localization, the average pain score was 2.5 (range: 1-5). Interestingly, the pain score for women who discussed the possible use of lidocaine jelly with the radiologists but still did not receive topical lidocaine jelly was also low at 6.5. For patients who received the lidocaine jelly only five minutes prior to injection, the average pain score was 6.ConclusionThe application of lidocaine jelly after the conclusion of needle localization, with a 15-40-minute delay prior to periareolar injections with 99mTc-SC for sentinel node lymphoscintigraphy, appears to substantially reduce the pain associated with the injection of 99mTc-SC.
Highlights
Lymphoscintigraphy is a common procedure used in oncology to identify and produce a “map” of the lymphatic system in order to identify the most likely first node of lymphatic drainage, the sentinel lymph node (SLN)
Technetium Tc-99m sulfur colloid (99mTc-SC) breast lymphoscintigraphy is commonly performed to identify the sentinel lymph node (SLN) in patients diagnosed with breast carcinoma undergoing lumpectomy
The procedure often requires intradermal injection of a radiopharmaceutical agent, usually technetium Tc-99m sulfur colloid (99mTc-SC). 99mTc-SC breast lymphoscintigraphy is commonly performed to determine the SLN in patients diagnosed with breast carcinoma undergoing lumpectomy [2]
Summary
Lymphoscintigraphy is a common procedure used in oncology to identify and produce a “map” of the lymphatic system in order to identify the most likely first node of lymphatic drainage, the sentinel lymph node (SLN). The procedure often requires intradermal injection of a radiopharmaceutical agent, usually technetium Tc-99m sulfur colloid (99mTc-SC). 99mTc-SC breast lymphoscintigraphy is commonly performed to determine the SLN in patients diagnosed with breast carcinoma undergoing lumpectomy [2]. Severe pain is often reported by patients during the injection of the radiopharmaceutical, and several methods have been proposed to decrease or eliminate this pain, albeit with inconsistent results [3]. Methods used to reduce the pain include the addition of bicarbonate and/or lidocaine into the radiopharmaceuticals. We report on the apparent effectiveness of periareolar topical lidocaine jelly
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
