PURPOSE: In a minority of breast cancer patients, lymphoscintigraphy shows no lymphatic drainage and 'hidden' sentinel nodes may remain undiscovered. The purpose of this study was to explore the additional value of the recently introduced hybrid SPECT/CT in breast cancer patients with axillary non-visualisation on planar images. The role of blue dye and careful palpation of the axilla was evaluated in patients in whom axillary sentinel nodes remained hidden after SPECT/CT. METHODS: Fifteen breast cancer patients with non-visualisation on planar lymphoscintigraphy and 13 women with only extra-axillary sentinel nodes underwent SPECT/CT following late planar imaging without re-injection of the radiopharmaceutical. RESULTS: SPECT/CT visualised lymphatic drainage in eight of the 15 patients (53%) with non-visualisation on planar imaging, depicted nine of the 14 harvested sentinel nodes (64%) and three of five tumour-positive sentinel nodes. In two of the 13 patients (15%) with only extra-axillary sentinel nodes on their planar lymphoscintigram, SPECT/CT showed an axillary sentinel node that appeared to be uninvolved. Careful exploration of the axilla with the combined use of blue dye, a gamma probe and intra-operative palpation revealed an axillary sentinel node in the remaining 18 patients. SPECT/CT showed the exact anatomical location of all visualised sentinel nodes. CONCLUSION: SPECT/CT discovered 'hidden' sentinel nodes in the majority of patients with non-visualisation, but was less valuable in patients with only extra-axillary lymphatic drainage on the planar images. Exploration of the axilla in patients with persistent non-visualisation improved the identification of axillary (involved) sentinel nodes.
PURPOSE: In a minority of breast cancerpatients, lymphoscintigraphy shows no lymphatic drainage and 'hidden' sentinel nodes may remain undiscovered. The purpose of this study was to explore the additional value of the recently introduced hybrid SPECT/CT in breast cancerpatients with axillary non-visualisation on planar images. The role of blue dye and careful palpation of the axilla was evaluated in patients in whom axillary sentinel nodes remained hidden after SPECT/CT. METHODS: Fifteen breast cancerpatients with non-visualisation on planar lymphoscintigraphy and 13 women with only extra-axillary sentinel nodes underwent SPECT/CT following late planar imaging without re-injection of the radiopharmaceutical. RESULTS: SPECT/CT visualised lymphatic drainage in eight of the 15 patients (53%) with non-visualisation on planar imaging, depicted nine of the 14 harvested sentinel nodes (64%) and three of five tumour-positive sentinel nodes. In two of the 13 patients (15%) with only extra-axillary sentinel nodes on their planar lymphoscintigram, SPECT/CT showed an axillary sentinel node that appeared to be uninvolved. Careful exploration of the axilla with the combined use of blue dye, a gamma probe and intra-operative palpation revealed an axillary sentinel node in the remaining 18 patients. SPECT/CT showed the exact anatomical location of all visualised sentinel nodes. CONCLUSION: SPECT/CT discovered 'hidden' sentinel nodes in the majority of patients with non-visualisation, but was less valuable in patients with only extra-axillary lymphatic drainage on the planar images. Exploration of the axilla in patients with persistent non-visualisation improved the identification of axillary (involved) sentinel nodes.
Authors: A M Derossis; J Fey; H Yeung; S D Yeh; A S Heerdt; J Petrek; K J VanZee; L L Montgomery; P I Borgen; H S Cody Journal: J Am Coll Surg Date: 2001-11 Impact factor: 6.113
Authors: Iris M C van der Ploeg; Renato A Valdés Olmos; Omgo E Nieweg; Emiel J Th Rutgers; Bin B R Kroon; Cornelis A Hoefnagel Journal: J Nucl Med Date: 2007-10-17 Impact factor: 10.057
Authors: D R Byrd; L K Dunnwald; D A Mankoff; B O Anderson; R E Moe; R S Yeung; E K Schubert; J F Eary Journal: Ann Surg Oncol Date: 2001-04 Impact factor: 5.344
Authors: P J Tanis; J W van Sandick; O E Nieweg; R A Valdés Olmos; E J T Rutgers; C A Hoefnagel; B B R Kroon Journal: Eur J Nucl Med Mol Imaging Date: 2002-03 Impact factor: 9.236
Authors: R A Valdés Olmos; P J Tanis; C A Hoefnagel; O E Nieweg; S H Muller; E J Rutgers; M L Kooi; B B Kroon Journal: Nucl Med Commun Date: 2001-05 Impact factor: 1.690
Authors: Siddharth S. Bass; Gary H. Lyman; Christa R. McCann; Ni Ni Ku; Claudia Berman; Kara Durand; Monica Bolano; Sarah Cox; Christopher Salud; Douglas S. Reintgen; Charles E. Cox Journal: Breast J Date: 1999-09 Impact factor: 2.431
Authors: Lynn T Dengel; Mitali J More; Patricia G Judy; Gina R Petroni; Mark E Smolkin; Patrice K Rehm; Stan Majewski; Mark B Williams; Craig L Slingluff Journal: Ann Surg Date: 2011-04 Impact factor: 12.969
Authors: Satish K Nune; Padmaja Gunda; Bharat K Majeti; Praveen K Thallapally; M Laird Forrest Journal: Adv Drug Deliv Rev Date: 2011-06-28 Impact factor: 17.873