Evaluation of axillary status in breast cancer. CT-based determination of sentinel lymph node size.
OBJECTIVE
To determine whether the location and size of sentinel lymph nodes (SLN) on CT are predictive of the axillary lymph node status in patients with breast cancer.


METHODS
Forty patients with confirmed breast cancer underwent 5-mm CT of both breasts and axillae and the most inferior lymph node in the affected axilla was designated the SLN. Based on CT assessment of the axillary lymph node status, 22 (55%) patients then underwent dye- and gamma probe (DGP)-guided SLN biopsy followed by axillary dissection; 18 (45%) underwent dissection without prior SLN biopsy. The localization and status of the SLN determined on CT and by DGP-guided biopsy were compared. Biopsied and excised nodes were subjected to histopathologic examinations.


RESULTS
All SLN identified on CT were close to the lateral thoracic artery and their localization corresponded well with SLN identified by the DGP-guided method. The positive predictive value of CT diagnosis was 100%. Histopathologic examination of excised nodes confirmed that none of the SLN biopsies was false-negative.


CONCLUSIONS
Our CT criteria were highly accurate for identification and diagnostic assessment of SLN and useful for evaluating the axillary status in patients with breast cancer.
Yuen
S
S
Department of Radiology, Kyoto Prefectural University of Medicine, Kamigyou, Kyoto, Japan.
Sawai
K
K
Ushijima
Y
Y
Okuyama
C
C
Yamagami
T
T
Yamada
K
K
Nishimura
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D004396:Coloring Agents; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis; D008751:Methylene Blue; D008875:Middle Aged; D010173:Palpation; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D020133:Reverse Transcriptase Polymerase Chain Reaction; D021701:Sentinel Lymph Node Biopsy; D014057:Tomography, X-Ray Computed
D004396:Coloring Agents; D008751:Methylene Blue