Impact of previous surgery on sentinel lymph node mapping: Hybrid SPECT/CT before and after a unilateral diagnostic breast excision

Autor: Annie Olsson, Fuat Celebioglu, Stefan Gabrielson, L. Zetterlund, Jana de Boniface, Rimma Axelsson, Jan Frisell
Rok vydání: 2016
Předmět:
Thorax
Adult
medicine.medical_specialty
Single Photon Emission Computed Tomography Computed Tomography
Adolescent
Breast surgery
medicine.medical_treatment
Concordance
Biopsy
Sentinel lymph node
Breast Neoplasms
030230 surgery
Mastectomy
Segmental
03 medical and health sciences
Young Adult
0302 clinical medicine
Breast cancer
medicine
Humans
Prospective Studies
Fibrocystic Breast Disease
Mammary Glands
Human
Technetium Tc 99m Aggregated Albumin
Aged
Hyperplasia
medicine.diagnostic_test
Papilloma
business.industry
Sentinel Lymph Node Biopsy
General Medicine
Middle Aged
medicine.disease
Surgery
Axilla
medicine.anatomical_structure
Carcinoma
Intraductal
Noninfiltrating
Fibroadenoma
030220 oncology & carcinogenesis
Female
Radiology
Lymph
Radiopharmaceuticals
Sentinel Lymph Node
business
Lymphoscintigraphy
Dilatation
Pathologic
Zdroj: Breast (Edinburgh, Scotland). 30
ISSN: 1532-3080
Popis: Background Earlier studies have shown conflicting results regarding the accuracy of sentinel lymph node biopsy after previous breast surgery, especially after a surgical biopsy. Purpose To compare lymph drainage patterns before and after a diagnostic unilateral surgical biopsy using the exact anatomical localisation of sentinel lymph nodes defined by SPECT/CT. Material and methods Thirty-seven women planned for unilateral surgical excision of an unsuspicious breast lesion were prospectively examined between September 2011 and January 2015. Hybrid SPECT/CT lymphoscintigraphy of the thorax and neck region with bilateral subareolar injections of 99mTc-Nanocoll was performed one week before and six weeks after surgery. The non-operated side served as a control. The primary outcome measure was the concordance between pre- and postoperative number and localisation of sentinel lymph nodes. Results Sentinel lymph node detection rate with SPECT/CT on operated sides was 91.9 per cent (34 of 37 procedures), to be compared with a detection rate of 93.7 per cent on all non-operated sides (104 of 111 procedures, P = 0.771). Partial or total concordance regarding the localisation and number of sentinel lymph nodes was 85.7 per cent (30 out of 35) on operated and 88.9 per cent (32 out of 36 patients) on non-operated breast sides (P = 0.735). Conclusion Breast surgery slightly decreased the concordance between pre- and postoperative sentinel lymph nodes, but this finding was not statistically significant. Our results thus support that it is feasible to perform a sentinel lymph node biopsy after previous breast excisional surgery with an acceptable level of safety.
Databáze: OpenAIRE
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