Scientific publications

Fluorodeoxyglucose positron emission tomography with sentinel lymph node biopsy for evaluation of axillary involvement in breast cancer

Gil-Rendo A, Zornoza G, García-Velloso MJ [SP], Regueira FM, Beorlegui C, Cervera M.
Department of General Surgery, Clinica Universitaria of Navarra, C/Pío XII 36, 31008 Pamplona, Navarre, Spain.

Magazine: The British Journal of Surgery

Date: Jun 1, 2006

Breast Cancer Area Nuclear Medicine [SP]

BACKGROUND
This study analysed the value of [(18)F]fluorodeoxyglucose positron emission tomography (FDG-PET) in detecting axillary lymph node involvement in women with breast cancer.

METHODS
In the first 150 women in this prospective study, axillary lymph node dissection (ALND) was performed regardless of the PET results. In a second group (125 women) FDG-PET was complemented with sentinel lymph node biopsy (SLNB) only in those who did not have pathological axillary uptake.

RESULTS
The sensitivity and specificity of FDG-PET in detecting axillary involvement was 84.5 and 98.5 per cent respectively in the whole series of 275 patients, with two false-positive and 22 false-negative results. False-negative results were associated with some intrinsic tumour characteristics. In 21 women, PET revealed pathological uptake, suggesting involvement of the internal mammary lymph node chain. Whole-body PET identified a second synchronous tumour in five asymptomatic patients and haematogenous metastases in two patients.

CONCLUSION
The high positive predictive value of PET (98.4 per cent) suggests that FDG uptake in the axilla could be an indication for full ALND without previous SLNB. 

CITATION  Br J Surg. 2006 Jun;93(6):707-12

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