Can [F-18] fluorodeoxyglucose positron emission tomography replace sentinel lymph node biopsy for the detection of axillary metastases in patients with early-stage breast cancer?
Turkish Journal of Medical Sciences, cilt.40, sa.1, ss.17-23, 2010 (SCI-Expanded, Scopus, TRDizin)
- Yayın Türü: Makale / Özet
- Cilt numarası: 40 Sayı: 1
- Basım Tarihi: 2010
- Doi Numarası: 10.3906/sag-0803-10
- Dergi Adı: Turkish Journal of Medical Sciences
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.17-23
- Anahtar Kelimeler: Breast cancer, sentinel lymph node biopsy, positron emission tomography, axillary metastasis
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Aim: To investigate the value of fluorodeoxyglucose positron emission tomography (FDG-PET) in detecting axillary involvement, and to compare its accuracy with sentinel lymph node biopsy (SLNB) in patients with clinically early-stage breast cancer. Materials and methods: Twenty-eight female patients with histologically-confirmed T1-2 breast cancer who were scheduled to have SLNB were included in the study. FDG-PET images were obtained 1-7 days prior to surgery with an intravenous injection of 370 MBq of FDG, while plasma glucose levels were maintained below 120 mg/dL. All the images were interpreted by 2 independent nuclear medicine specialists, who were blinded to the histological diagnoses. SLNB was performed in standard fashion with peri-tumoral injection of isosulphan blue dye. In all cases, a level I-II axillary dissection was performed following SLNB. Sentinel nodes were processed after formalin fixation; no frozen sections were used. Results: Thirteen (46%) patients were found to have axillary involvement. SLNB (an average of 2.3 LNs removed per patient) demonstrated metastases in all 13 patients. The diagnostic accuracy of FDG-PET was as follows: true-positive in 4 out of 13 patients (overall sensitivity = 31%), false-negative in 1 patient with metastasis (overall specificity = 94%), positive predictive value = 80%, negative predictive value = 63%, and accuracy = 68%. Conclusion: FDG-PET appears to be significantly less accurate than SLNB at detecting axillary metastases. In patients with an axillary-positive PET scan, however, axillary lymph node dissection may be performed without prior SLNB. © Tübi̇tak.