title: Prediction of sentinel lymph node status using single-photon emission computed tomography (SPECT)/computed tomography (CT) imaging of breast cancer.
abstract: OBJECTIVE
  Single-photon emission computed tomography (SPECT)/computed tomography (CT) improves the anatomical identification of sentinel lymph nodes (SNs). We aimed to evaluate the possibility of predicting the SN status using SPECT/CT.
  
  
  METHODS
  SN mapping using a SPECT/CT system was performed in 381 cases of clinically node-negative, operable invasive breast cancer. We evaluated and compared the values of SN mapping on SPECT/CT, the findings of other modalities and clinicopathological factors in predicting the SN status.
  
  
  RESULTS
  Patients with SNs located in the Level I area were evaluated. Of the 355 lesions (94.8 %) assessed, six cases (1.6 %) were not detected using any imaging method. According to the final histological diagnosis, 298 lesions (78.2 %) were node negative and 83 lesions (21.7 %) were node positive. The univariate analysis showed that SN status was significantly correlated with the number of SNs detected on SPECT/CT in the Level I area (P = 0.0048), total number of SNs detected on SPECT/CT (P = 0.011), findings of planar lymphoscintigraphy (P = 0.011) and findings of a handheld gamma probe during surgery (P = 0.012). According to the multivariate analysis, the detection of multiple SNs on SPECT/CT imaging helped to predict SN metastasis.
  
  
  CONCLUSIONS
  The number of SNs located in the Level I area detected using the SPECT/CT system may be a predictive factor for SN metastasis.
authors.affiliation: Department of Breast and Endocrine Surgery, Faculty of Medical Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, Kumamoto, 860-8556, Japan.
authors.forename: Mai
authors.initials: M
authors.lastname: Tomiguchi
authors.affiliation: Department of Breast and Endocrine Surgery, Faculty of Medical Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, Kumamoto, 860-8556, Japan.
authors.forename: Mutsuko
authors.initials: M
authors.lastname: Yamamoto-Ibusuki
authors.affiliation: Department of Breast and Endocrine Surgery, Faculty of Medical Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, Kumamoto, 860-8556, Japan. ys-yama@triton.ocn.ne.jp.|Department of Molecular-Targeting Therapy for Breast Cancer, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, Kumamoto, 860-8556, Japan. ys-yama@triton.ocn.ne.jp.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yamamoto
authors.affiliation: Department of Breast and Endocrine Surgery, Faculty of Medical Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, Kumamoto, 860-8556, Japan.
authors.forename: Mamiko
authors.initials: M
authors.lastname: Fujisue
authors.affiliation: Department of Diagnostic Radiology, Faculty of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, Kumamoto, 860-8556, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Shiraishi
authors.affiliation: Department of Breast and Endocrine Surgery, Faculty of Medical Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, Kumamoto, 860-8556, Japan.
authors.forename: Touko
authors.initials: T
authors.lastname: Inao
authors.affiliation: Department of Breast and Endocrine Surgery, Faculty of Medical Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, Kumamoto, 860-8556, Japan.
authors.forename: Kei-ichi
authors.initials: K
authors.lastname: Murakami
authors.affiliation: Department of Surgical Pathology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, Kumamoto, 860-8556, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Honda
authors.affiliation: Department of Diagnostic Radiology, Faculty of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, Kumamoto, 860-8556, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yamashita
authors.affiliation: Department of Surgical Pathology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, Kumamoto, 860-8556, Japan.
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Iyama
authors.affiliation: Department of Breast and Endocrine Surgery, Faculty of Medical Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, Kumamoto, 860-8556, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Iwase
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis; D061305:Lymphoscintigraphy; D008875:Middle Aged; D011237:Predictive Value of Tests; D021701:Sentinel Lymph Node Biopsy; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
keywords: Breast cancer; Metastasis; SN mapping; SPECT/CT; Sentinel lymph node biopsy