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Determination of indication for sentinel lymph node biopsy in clinical node-negative breast cancer using preoperative 18F-fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging.
Jpn J Clin Oncol. 2009 Jan; 39(1):16-21.JJ

Abstract

OBJECTIVE

Sentinel node biopsy (SNB) is indicated for axillary lymph node metastasis-negative cases (N0), but clarification of the indication may increase treatment efficiency. Fluorine-18-labeled 2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) may have a high positive predictive value in diagnosis of axillary lymph node metastasis.

METHODS

Ninety-two breasts/axillae were analyzed retrospectively in 90 patients (median age 54.6-year old, median primary tumor 1.7 cm). FDG-PET/computed tomography was used to indicate SNB in N0 cases. Axillary lymph node dissection (ALND) was performed in cases that were axillary lymph node metastasis-positive (PET N+) on FDG-PET/CT.

RESULTS

Seventy-four (80.4%) and 18 (19.6%) of the 92 axillae were diagnosed as metastasis-negative (PET N0) and PET N+, respectively, by FDG-PET/CT. SNB was performed in 51 of the 74 PET N0 axillae. ALND was performed in 23 PET N0 axillae (at the patients' request) and in all 18 PET N+ axillae. Of the 74 PET N0 axillae, 14 were metastasis-positive (pN+) and 60 were pN0 pathologically, and of the 18 PET N+ axillae, 13 were pN+ and five were pN0. The sensitivity and specificity of FDG-PET/CT for diagnosis of axillary metastasis were 48.1 and 92.3%, respectively, and the positive and negative predictive values were 72.2 and 81.1%, respectively.

CONCLUSION

The positive detection rate on FDG-PET/CT was insufficient for determining an indication of SNB. However, use of an appropriate cut-off for SUV(max) (the positive rate was 90.9% with a cut-off of 2.0) and exclusion of surgically biopsied cases may achieve a clinically applicable positive detection rate.

Authors+Show Affiliations

Department of Breast and Endocrine Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan. ntaira@md.okayama-u.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18997183

Citation

Taira, Naruto, et al. "Determination of Indication for Sentinel Lymph Node Biopsy in Clinical Node-negative Breast Cancer Using Preoperative 18F-fluorodeoxyglucose Positron Emission Tomography/computed Tomography Fusion Imaging." Japanese Journal of Clinical Oncology, vol. 39, no. 1, 2009, pp. 16-21.
Taira N, Ohsumi S, Takabatake D, et al. Determination of indication for sentinel lymph node biopsy in clinical node-negative breast cancer using preoperative 18F-fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging. Jpn J Clin Oncol. 2009;39(1):16-21.
Taira, N., Ohsumi, S., Takabatake, D., Hara, F., Takashima, S., Aogi, K., Takashima, S., Inoue, T., Sugata, S., & Nishimura, R. (2009). Determination of indication for sentinel lymph node biopsy in clinical node-negative breast cancer using preoperative 18F-fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging. Japanese Journal of Clinical Oncology, 39(1), 16-21. https://doi.org/10.1093/jjco/hyn120
Taira N, et al. Determination of Indication for Sentinel Lymph Node Biopsy in Clinical Node-negative Breast Cancer Using Preoperative 18F-fluorodeoxyglucose Positron Emission Tomography/computed Tomography Fusion Imaging. Jpn J Clin Oncol. 2009;39(1):16-21. PubMed PMID: 18997183.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Determination of indication for sentinel lymph node biopsy in clinical node-negative breast cancer using preoperative 18F-fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging. AU - Taira,Naruto, AU - Ohsumi,Shozo, AU - Takabatake,Daisuke, AU - Hara,Fumikata, AU - Takashima,Seiki, AU - Aogi,Kenjiro, AU - Takashima,Shigemitsu, AU - Inoue,Takeshi, AU - Sugata,Shigenori, AU - Nishimura,Rieko, Y1 - 2008/11/08/ PY - 2008/11/11/pubmed PY - 2009/1/23/medline PY - 2008/11/11/entrez SP - 16 EP - 21 JF - Japanese journal of clinical oncology JO - Jpn J Clin Oncol VL - 39 IS - 1 N2 - OBJECTIVE: Sentinel node biopsy (SNB) is indicated for axillary lymph node metastasis-negative cases (N0), but clarification of the indication may increase treatment efficiency. Fluorine-18-labeled 2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) may have a high positive predictive value in diagnosis of axillary lymph node metastasis. METHODS: Ninety-two breasts/axillae were analyzed retrospectively in 90 patients (median age 54.6-year old, median primary tumor 1.7 cm). FDG-PET/computed tomography was used to indicate SNB in N0 cases. Axillary lymph node dissection (ALND) was performed in cases that were axillary lymph node metastasis-positive (PET N+) on FDG-PET/CT. RESULTS: Seventy-four (80.4%) and 18 (19.6%) of the 92 axillae were diagnosed as metastasis-negative (PET N0) and PET N+, respectively, by FDG-PET/CT. SNB was performed in 51 of the 74 PET N0 axillae. ALND was performed in 23 PET N0 axillae (at the patients' request) and in all 18 PET N+ axillae. Of the 74 PET N0 axillae, 14 were metastasis-positive (pN+) and 60 were pN0 pathologically, and of the 18 PET N+ axillae, 13 were pN+ and five were pN0. The sensitivity and specificity of FDG-PET/CT for diagnosis of axillary metastasis were 48.1 and 92.3%, respectively, and the positive and negative predictive values were 72.2 and 81.1%, respectively. CONCLUSION: The positive detection rate on FDG-PET/CT was insufficient for determining an indication of SNB. However, use of an appropriate cut-off for SUV(max) (the positive rate was 90.9% with a cut-off of 2.0) and exclusion of surgically biopsied cases may achieve a clinically applicable positive detection rate. SN - 1465-3621 UR - https://www.unboundmedicine.com/medline/citation/18997183/Determination_of_indication_for_sentinel_lymph_node_biopsy_in_clinical_node_negative_breast_cancer_using_preoperative_18F_fluorodeoxyglucose_positron_emission_tomography/computed_tomography_fusion_imaging_ L2 - https://academic.oup.com/jjco/article-lookup/doi/10.1093/jjco/hyn120 DB - PRIME DP - Unbound Medicine ER -