Is anterior oblique view alone in surgical position sufficient for preoperative sentinel lymph node mapping in breast cancer? A quantitative comparative analysis with conventional views.
OBJECTIVE
Since the anterior projection alone has several limitations in the conventional preoperative sentinel lymph node (SLN) mapping, multiple projections including anterior oblique (AO) view are preferred. There are many AO acquisition techniques described in the literature but none of them creates an image which fully reflects the surgical perspective. We aimed to compare the AO view in the surgical position with the conventional projections according to quantitative parameters.


METHODS
Sixty female breast cancer patients entered the study. Two hours after the radiotracer injection, preoperative SLN mapping at anterior, lateral and 35 degrees AO projections in surgical position was performed. For each projection, mapping success rate (MSR), the mean number of SLNs, lymphatic channel visualization rate, image contrast and distance measurements between each SLN and between the SLNs and the injection site were recorded.


RESULTS
The best MSR and image contrast for the first and the consecutive axillary SLNs were found at the AO projection. The longest distance between the injection site and the SLNs and between the two SLNs were observed at the AO views. Although the AO view gave the best results for intramammary SLNs the difference was not statistically significant from the anterior view.


CONCLUSIONS
The 35 degrees AO view in the surgical position was superior to the anterior and lateral projections. Therefore, the simple 4-min AO view in the surgical position may entirely reflect the surgeon's perspective and could be used safely alone in the preoperative lymphatic mapping for breast cancer patients.
Dede
F
F
Department of Nuclear Medicine, Marmara University Medical School, Istanbul, Turkey. fuatdede@yahoo.com
Ones
T
T
Gulluoglu
B M
BM
Memis
H
H
Farsakoglu
Z
Z
Caliskan
B
B
Atasoy
B M
BM
Erdil
T Y
TY
Inanir
S
S
Turoglu
H T
HT
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care; D011857:Radiographic Image Interpretation, Computer-Assisted; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy; D025321:Surgery, Computer-Assisted; D017556:Technetium Compounds; D017971:Tin Compounds
D019275:Radiopharmaceuticals; D017556:Technetium Compounds; D017971:Tin Compounds; C033493:technetium Tc 99m tin colloid