title: Breast sentinel lymph node navigation with three-dimensional computed tomography-lymphography: a 12-year study.
abstract: OBJECTIVE
  To evaluate the utility of three-dimensional (3D) computed tomography (CT)-lymphography (LG) breast sentinel lymph node navigation in our institute.
  
  
  METHODS
  Between 2002 and 2013, we preoperatively identified sentinel lymph nodes (SLNs) in 576 clinically node-negative breast cancer patients with T1 and T2 breast cancer using 3D CT-LG method. SLN biopsy (SLNB) was performed in 557 of 576 patients using both the images of 3D CT-LG for guidance and the blue dye method.
  
  
  RESULTS
  Using 3D CT-LG, SLNs were visualized in 569 (99%) of 576 patients. Of 569 patients, both lymphatic draining ducts and SLNs from the peritumoral and periareolar areas were visualized in 549 (96%) patients. Only SLNs without lymphatic draining ducts were visualized in 20 patients. Drainage lymphatic pathways visualized with 3D CT-LG (549 cases) were classified into four patterns: single route/single SLN (355 cases, 65%), multiple routes/single SLN (59 cases, 11%) single route/multiple SLNs (62 cases, 11%) and multiple routes/multiple SLNs (73 cases, 13%). SLNs were detected in 556 (99.8%) of 557 patients during SLNB.
  
  
  CONCLUSIONS
  CT-LG is useful for preoperative visualization of SLNs and breast lymphatic draining routes. This preoperative method should contribute greatly to the easy detection of SLNs during SLNB.
authors.affiliation: Department of Digestive Surgery and Surgical Oncology (Department of Surgery II), Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8505, Japan. syamamo@yamaguchi-u.ac.jp.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Department of Radiology, St. Hill Hospital, Yamaguchi, Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Suga
authors.affiliation: Department of Digestive Surgery and Surgical Oncology (Department of Surgery II), Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Maeda
authors.affiliation: Department of Digestive Surgery and Surgical Oncology (Department of Surgery II), Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Maeda
authors.affiliation: Department of Digestive Surgery and Surgical Oncology (Department of Surgery II), Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yoshimura
authors.affiliation: Department of Digestive Surgery and Surgical Oncology (Department of Surgery II), Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Oka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D003287:Contrast Media; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007479:Iopamidol; D008220:Lymphography / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D011300:Preoperative Care; D000071036:Sentinel Lymph Node / Q000000981:diagnostic imaging* / Q000473:pathology; D021701:Sentinel Lymph Node Biopsy / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000379:methods*; D014463:Ultrasonography / Q000379:methods
chemical_list: D003287:Contrast Media; D007479:Iopamidol
keywords: Breast cancer; Computed tomography; Lymphography; Sentinel lymph node