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.
Breast cancer, sentinel lymph node biopsy, positron emission tomography, axillary metastasis
GÖRGÜLÜ, SEMİH; CAN, MEHMET FATİH; HANÇERLİOĞULLARI, OĞUZ; ARSLAN, NURİ; ÖZTÜRK, ERKAN; ÖZTÜRK, EMEL; BALKAN, MÜJDAT; and TUFAN, TURGUT
"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: Vol. 40:
1, Article 3.
Available at: https://journals.tubitak.gov.tr/medical/vol40/iss1/3