Application of Preoperative Computed Tomographic Lymphography for Precise Sentinel Lymph Node Biopsy in Breast Cancer Patients

Overview

Journal BMC Surg

Publisher Biomed Central

Specialty General Surgery

Date 2021 Apr 10

PMID 33836721

Citations 2

Authors

Shishuai Wen

Yiran Liang

Xiaoli Kong

Baofeng Liu

Tingting Ma

Yeqing Zhou

Liyu Jiang

Xiaoyan Li

Qifeng Yang

Affiliations

Soon will be listed here.

Abstract

Background: In light of the extensive application of sentinel lymph node biopsy (SLNB) in clinically node-negative breast cancer patients and the recently investigated failure of SLNB after lumpectomy, it has become important to explore methods for preoperative mapping of sentinel lymph nodes (SLNs) and their lymphatics to direct precise SLNB and improve the identification rate of SLNs.

Methods: Twenty-seven patients with suspected breast cancer based on the results of the clinical examination and imaging were enrolled in the study. Computed tomographic lymphography (CTLG) followed by CT three-dimensional reconstruction was performed to determine the localization of SLNs and lymphatics on the body surface preoperatively. Intraoperatively combined staining with methylene blue and indocyanine green was used to evaluate the accuracy and feasibility of CTLG.

Results: SLNs and lymphatics from the breast were identified using CTLG in all patients, and preoperative SLNs and lymphatics localization on the body surface showed a significant role in the selection of operative incision and injection points. The accuracy rate of SLN and lymphatic detection by CTLG was 92.6% compared with intraoperatively combined staining. Moreover, preoperative CTLG performed well in SLN number detection, and the accuracy rate was 95.2%.

Conclusion: We evaluate the procedure and application of preoperative CTLG in the superficial localization of SLNs and lymphatics, which may lead to a decreased incidence of cutting off the lymphatics of SLNs and consequently more rapid and accurate SLN detection. This method promotes personalized SLN mapping, providing detailed information about the number and anatomical location of SLNs and lymphatics for adequate surgical planning for breast cancer patients.

Citing Articles

Advanced diagnostic imaging of sentinel lymph node in early stage breast cancer.

Li P, Sun D J Clin Ultrasound. 2022; 50(3):415-421.

PMID: 35092313 PMC: 9303781. DOI: 10.1002/jcu.23151.

Contrast-Enhanced Ultrasound for Precise Sentinel Lymph Node Biopsy in Women with Early Breast Cancer: A Preliminary Study.

Zhu Y, Fan X, Yang D, Dong T, Jia Y, Nie F Diagnostics (Basel). 2021; 11(11).

PMID: 34829452 PMC: 8624576. DOI: 10.3390/diagnostics11112104.

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