Sentinel nodes identified by computed tomography-lymphography accurately stage the axilla in patients with breast cancer

BMC Medical Imaging

Research Article

Atsushi Noguchi¹  Hiroshi Sumino¹  Katsuyuki Nakanishi¹  Takashi Horinouchi¹  Kazuyoshi Motomura² 

[1] Departments of Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, 537-8511, Osaka, Japan;Departments of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, 537-8511, Osaka, Japan;

关键词: Sentinel node;    Breast cancer;    Computed tomography;    Lymphography;    Staging;   

DOI  :  10.1186/1471-2342-13-42

 received in 2013-05-12, accepted in 2013-12-04,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundSentinel node biopsy often results in the identification and removal of multiple nodes as sentinel nodes, although most of these nodes could be non-sentinel nodes. This study investigated whether computed tomography-lymphography (CT-LG) can distinguish sentinel nodes from non-sentinel nodes and whether sentinel nodes identified by CT-LG can accurately stage the axilla in patients with breast cancer.MethodsThis study included 184 patients with breast cancer and clinically negative nodes. Contrast agent was injected interstitially. The location of sentinel nodes was marked on the skin surface using a CT laser light navigator system. Lymph nodes located just under the marks were first removed as sentinel nodes. Then, all dyed nodes or all hot nodes were removed.ResultsThe mean number of sentinel nodes identified by CT-LG was significantly lower than that of dyed and/or hot nodes removed (1.1 vs 1.8, p <0.0001). Twenty-three (12.5%) patients had ≥2 sentinel nodes identified by CT-LG removed, whereas 94 (51.1%) of patients had ≥2 dyed and/or hot nodes removed (p <0.0001). Pathological evaluation demonstrated that 47 (25.5%) of 184 patients had metastasis to at least one node. All 47 patients demonstrated metastases to at least one of the sentinel nodes identified by CT-LG.ConclusionsCT-LG can distinguish sentinel nodes from non-sentinel nodes, and sentinel nodes identified by CT-LG can accurately stage the axilla in patients with breast cancer. Successful identification of sentinel nodes using CT-LG may facilitate image-based diagnosis of metastasis, possibly leading to the omission of sentinel node biopsy.

【 授权许可】

CC BY   
© Motomura et al.; licensee BioMed Central Ltd. 2013