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Resume Introduction L’evaluation du statut ganglionnaire dans le cancer du sein est un important facteur pronostique du risque de recidive. En cas de tumeur impalpable, le reperage isotopique Sentinel Node Occult Lesion Localization (SNOLL) permet avec une injection peri-tumorale un reperage a la fois de la tumeur et du ganglion sentinelle (GS). L’objectif etait de demontrer que l’identification du GS en lymphoscintigraphie preoperatoire (LSP) etait inferieure apres technique SNOLL qu’apres la technique du GS usuelle (reperage seul du ganglion sentinelle). Methodes Il s’agit d’une etude retrospective comparative menee sur 100 patientes traitees entre mai 2017 et janvier 2019 pour un cancer du sein dans le service de senologie du centre hospitalier universitaire de Montpellier. Le taux d’identification du GS en LSP apres injection au contact de la tumeur (SNOLL) etait compare a celui apres injection dans le quadrant atteint du sein (technique usuelle). Resultats Soixante-cinq patientes ont beneficie d’un reperage par SNOLL et 35 d’une injection usuelle. Les taux d’echec de detection du GS etaient respectivement de 34 % et 11 % en LSP (p = 0,02), de 17 et 9 % en peroperatoire et de 11 et 6 % avec une detection isotopique et colorimetrique. Discussion Le taux d’echec d’identification en LSP est plus important avec la technique de SNOLL. Une migration complementaire du traceur dans l’intervalle de temps entre l’injection du produit et le geste operatoire permet une diminution du taux d’echec. L’association avec une technique colorimetrique permettant d’augmenter le taux d’identification, il semble legitime de poursuivre la double detection.

Objectives Platinum salts are commonly used in hyperthermic intraperitoneal chemotherapy (HIPEC) for digestive tract cancer treatment. During HIPEC with oxaliplatin for peritoneal metastases (PMs) treatment, the ovaries are directly exposed to the drug, questioning about ovarian resection and the potential impact of the drug on ovarian functionality, especially in young women of childbearing age. The goal of this work is to understand unwanted damages to the ovaries during HIPEC therapy by the determination of the concentration and distribution of platinum in ovaries in order to address its potential toxicity. Methods Mass spectrometry imaging techniques, matrix-assisted laser desorption ionization mass spectrometry (MALDI-MS) and laser ablation inductively coupled plasma mass spectrometry (LA-ICP MS), were used to study the penetration of oxaliplatin in ovaries after HIPEC treatment. Results MALDI-MS allowed the localization of an oxaliplatin-derivative (m/z 456.2) at the periphery of the ovaries. The quantitative LA-ICP MS maps confirmed the localization of elemental platinum as well as in the central part of ovaries from patients who received a previous platinum salt-based chemotherapy. Conclusions LA-ICP MS images showed that platinum diffusion was extended in cases of previous systemic treatment, questioning about platinum derivatives gonado-toxicity when combining the two treatments.

International audience; One third of operated breast cancers are clinically occult.1 Nonpalpable breast cancers (NPBC) require accurate intraoperative guidance to achieve complete tumor removal.1 Incomplete removal of lesions increases the rate of reexcision, worsening patient's discomfort, and cosmetic outcomes.1 Localization techniques suffer from various limitations. Indocyanine green (ICG) fluorescence is commonly used for intraoperative identification of sentinel lymph nodes (SLN).2 Its pertinence for NPBC is still underestimated. Darkness required in surgery room with available cameras has been a limitation for its use. We evaluated ICG method for NPBC localization, guided by a probe in ambient light, inspired by radioguided occult lesion localization (ROLL).

International audience; Introduction: Preoperative localization procedures of occult breast cancer (radioisotopic and wire localization) are invasive and uncomfortable. We have evaluated a novel technique which allows a virtual localization.Material and methods: Our retrospective study focused on patients treated for occult and unifocal breast cancer from September 2016 to June 2017. All patients had radioisotopic preoperative localization. We included patients who had a preoperative prone Magnetic Resonance Imaging (MRI) and an intraoperative 3D optical scan. During surgery, the surgeon localized the tumor thanks to a gamma detection probe and marked the localization on the skin with a black marker. The breast was then optically scanned. MRI was adjusted to the optical surface to match the exact breast position in the Operating Room. The virtual localization provided by the 3D breast modeling tool was retrospectively compared with the radioisotopic localization, defined as the pen mark visible in the optical scan.Results: Nine patients were included in this feasibility study. Tumors were successfully localized in the respective breast quadrant. The mean cutaneous distance between virtual and radioisotopic localization was 1.4 cm in patients with low breast volume (5/9) and 2.8 cm in those with large breast volume (4/9).Conclusion: We developed a research prototype which enables virtual preoperative localization of nonpalpable breast lesions using MRI images and intraoperative optical scanning. Parameter optimization is required and will lead to a precise and noninvasive tool. By adding augmented reality, it will be possible to initiate a prospective study to compare this tool with the traditional localizations.