SPECT/CT Lymphoscintigraphy Accurately Localizes Clipped and Sentinel Nodes After Neoadjuvant Chemotherapy in Node-Positive Breast Cancer.

Autor:	Dilege E; From the Breast Surgery, Department of General Surgery, Koc University School of Medicine., Celik B; Breast Surgery, Department of General Surgery, Koc University Hospital., Falay O; Departments of Nuclear Medicine., Boge M; Radiology., Sucu S; General Surgery., Toprak S; Breast Surgery, Department of General Surgery, Koc University Hospital., Agcaoglu O; From the Breast Surgery, Department of General Surgery, Koc University School of Medicine., Kapucuoglu N; Pathology, Koc University School of Medicine, Istanbul, Turkey., Demirkol O; Departments of Nuclear Medicine.
Jazyk:	angličtina
Zdroj:	Clinical nuclear medicine [Clin Nucl Med] 2023 Jul 01; Vol. 48 (7), pp. 594-599. Date of Electronic Publication: 2023 Apr 17.
DOI:	10.1097/RLU.0000000000004669
Abstrakt:	Purpose: The aim of this study was to evaluate the impact of SPECT/CT lymphoscintigraphy on targeted axillary dissection (TAD) in node-positive breast cancer (BC) patients who had undergone neoadjuvant chemotherapy (NAC). Methods: Sixty-two female BC patients with biopsy-confirmed axillary nodal metastases underwent NAC, followed by breast surgery with TAD. A metallic clip was placed in the sampled LN before NAC. On the day of surgery, a periareolar intradermal 99m Tc-nanocolloid injection was administered, followed by SPECT/CT lymphoscintigraphy. The clipped nodes were localized on CT images, assessed for 99m Tc uptake before surgery, and confirmed during the procedure. Results: T1-4, N1-2 patients were enrolled in the study. All patients underwent sentinel lymph node (SLN) biopsy. The clipped node was the SLN in 54 (88.5%) patients. In 3 patients (4.9%), a clip was found in a nonsentinel lymph node. In 4 patients, the clips were not visible on SPECT/CT images, and lymph nodes were not found during the procedure. SPECT/CT correctly localized the clipped lymph node in all patients. The overall false-negative rate for TAD was 3.33%. The mean follow-up duration was 29 months, and there were no axillary recurrences. Conclusions: SPECT/CT lymphoscintigraphy can accurately localize clipped nodes and SLNs after NAC in patients with node-positive BC. Competing Interests: Conflicts of interest and sources of funding: none declared. (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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