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Erschienen in:
11.01.2015 | Original Article
Breast sentinel lymph node navigation with three-dimensional computed tomography–lymphography: a 12-year study
Erschienen in: Breast Cancer | Ausgabe 3/2016
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Purpose
To evaluate the utility of three-dimensional (3D) computed tomography (CT)−lymphography (LG) breast sentinel lymph node navigation in our institute.
Patients and 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.
Conclusion
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.