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Turkish Journal of Medical Sciences

DOI

10.3906/sag-0803-10

Abstract

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.

Keywords

Breast cancer, sentinel lymph node biopsy, positron emission tomography, axillary metastasis

First Page

17

Last Page

23

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