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BMC Medical Imaging
Published in: BMC Medical Imaging 1/2013

Open Access 01-12-2013 | Research article

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

Authors: Kazuyoshi Motomura, Hiroshi Sumino, Atsushi Noguchi, Takashi Horinouchi, Katsuyuki Nakanishi

Published in: BMC Medical Imaging | Issue 1/2013

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Abstract

Background

Sentinel 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.

Methods

This 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.

Results

The 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.

Conclusions

CT-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.
Appendix
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Metadata
Title
Sentinel nodes identified by computed tomography-lymphography accurately stage the axilla in patients with breast cancer
Authors
Kazuyoshi Motomura
Hiroshi Sumino
Atsushi Noguchi
Takashi Horinouchi
Katsuyuki Nakanishi
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Medical Imaging / Issue 1/2013
Electronic ISSN: 1471-2342
DOI
https://doi.org/10.1186/1471-2342-13-42

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