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Comparative efficacy of positron emission tomography and ultrasonography in preoperative evaluation of axillary lymph node metastases in breast cancer

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Abstract

Purpose

In primary breast cancer, axillary nodal status is the most powerful predictive factor of recurrence. However, axillary lymph node dissection may cause surgical complications. If preoperative evaluation of axillary lymph node metastases is possible, unnecessary axillary lymph node dissections can be avoided. The purpose of this study was to evaluate the efficacy of positron emission tomography (PET) on detection of axillary lymph node metastases in breast cancer.

Methods

PET scans of the axilla were obtained in 32 patients with primary breast cancer. All patients fasted for at least 4 hours before the examination. After transmission scans for attenuation correction were performed, emission scans after intravenous injection of 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) were obtained.

Results

Overall accuracy of PET alone, ultrasonography alone, and in combination in the detection of axillary metastases were 82%, 79%, and 85% respectively.

Conclusion

There were no significant differences between PET, ultrasonography, and PET in combination with ultrasonography regarding sensitivity, specificity and accuracy in the detection of axillary metastases.

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Abbreviations

PET:

Positron emission tomography

FDG:

2-[l8F]-fluoro-2-deoxy-D-glucose

References

  1. Fisher B, Bauer M, Wickerham L,et al: Relation of number of positive axillary nodes to the prognosis of patients with primary breast cancer; An NSABP update.Cancer 52:1551–1557, 1983.

    Article  PubMed  CAS  Google Scholar 

  2. Pezner RD, Pattterson MP, Hill LR: Arm edema in patients treated conservatively for breast cancer; Relationship to patient’s age and axillary node dissection technique.Int J Radiat Oncol Biol Phys 12:2079–2083, 1986.

    PubMed  CAS  Google Scholar 

  3. Assa J: The intercostobrachial nerve in radical mastectomy.J Surg Oncol 6:123–126, 1974.

    Article  PubMed  CAS  Google Scholar 

  4. Warburg O: On the origin of cancer cells.Science 123:309–314, 1956.

    Article  PubMed  CAS  Google Scholar 

  5. Kubota R, Kubota K, Yamada S,et al: Microautoradiographic study for the differentiation of intratumoral macrophages, granulation tissues and cancer cells by the dynamics of fluorine-18-fluorodeoxyglucose uptake.J Nucl Med 35:104–112, 1994.

    PubMed  CAS  Google Scholar 

  6. Di Chiro G: Positron emission tomography using (18F) fluorodeoxy-glucose in brain tumors; A powerful diagnostic and prognostic tool.Invest Radiol 22:360–371, 1987.

    Article  PubMed  CAS  Google Scholar 

  7. Rege S, Maass A, Chaiken L,et al: Use of positron emission tomography with fluorodeoxyglucose in patients with extracranial head and neck cancers.Cancer 73:3047–3058, 1994.

    Article  PubMed  CAS  Google Scholar 

  8. Laubenbacher C, Saumweber D, Wagener-Manslau C,et al: Comparison of fluorine-18-fluorodeoxy-glucose PET, MRI and endoscopy for staging of head and neck squamous-cell carcinomas.J Nucl Med 36:1747–1757, 1995.

    PubMed  CAS  Google Scholar 

  9. Wahl RL, Quint LE, Greenough RL,et al: Staging of mediastinal non-small cell lung cancer with FDG PET, CT, and fusion images; Preliminary prospective evaluation.Radiology 191:371–377, 1994.

    PubMed  CAS  Google Scholar 

  10. Lewis P, Griffin S, Marsden P,et al: Whole-body 18F- fluorodeoxyglucose positron emission tomography in preoperative evaluation of lung cancer.Lancet 344:1265–1266, 1994.

    Article  PubMed  CAS  Google Scholar 

  11. Bares R, Klever P, Hauptmann S,et al: F-18 fluorodeoxyglucose PET in vivo evaluation of pancreatic cancer.Radiology 192:79–86, 1994.

    PubMed  CAS  Google Scholar 

  12. Okada J, Yoshikawa K, Itami M,et al: Positron emission tomography using fluorine-18-fluorodeoxy-glucose in malignant lymphoma; A comparison with proliferative activity.J Nucl Med 33:325–329, 1992.

    PubMed  CAS  Google Scholar 

  13. Griffeth LK, Dehdashti F, McGuire AH,et al: PET evaluation of soft-tissue masses with fluorine-18 fluoro-2-deoxy-D-glucose.Radiology 182:185–194, 1992.

    PubMed  CAS  Google Scholar 

  14. Adler LP, Blair HF, Makley JT,et al: Noninvasive grading of musculoskeletal tumors using PET.J Nucl Med 32:1508–1512, 1991.

    PubMed  CAS  Google Scholar 

  15. Wahl RL, Cody RL, Hutchins GD,et al: Primary and metastatic breast carcinoma; Initial clinical evaluation with PET with the radiolabeled glucose analog 2- [18F]-fluoro-2-deoxy-D-glucose.Radiology 179:765–770, 1991.

    PubMed  CAS  Google Scholar 

  16. Adler LP, Crowe JP, Al-Kaisi NK,et al: Evaluation of breast masses and axillary lymph nodes with [F-18]- 2-deoxy-2-fluoro-D-glucose PET.Radiology 187:743–750, 1993.

    PubMed  CAS  Google Scholar 

  17. Bombardieri E, Crippa F, Maffioli L,et al: Axillary lymph node metastases detection with nuclear medicine approaches in patients with newly diagnosed breast cancer; Can positron emission tomography (PET) with18F-FDG be considered as the best method?Int J Oncol 8:693–699, 1996.

    Google Scholar 

  18. Holle LH, Trampert L, Lung-Kurt S,et al: Investigations of breast tumors with fluorine-18-fluorodeoxy- glucose and SPECT.J Nucl Med 15:61–66, 1996.

    Google Scholar 

  19. Kubota K, Matsuzawa T, Amemiya T,et al: Imaging of breast cancer with [18F]fluorodeoxyglucose and positron emission tomography.J Comput Assist Tomogr 13:1097–1098, 1989.

    PubMed  CAS  Google Scholar 

  20. Tse NY, Hoh CK, Hawkins RAet al: The application of positron emission tomographic imaging with fluorodeoxyglucose to the evaluation of breast disease.Ann Surg 216:23–33, 1992.

    Article  Google Scholar 

  21. Wahl RL, Helvie MA, Chang AE,et al: Detection of breast cancer in women after augmentation mammoplasty using fluorine-18-fluorodeoxyglucose-PET.J Nucl Med 35:872–875, 1994.

    PubMed  CAS  Google Scholar 

  22. Pietrzyk U, Scheidhauer K, Scharl A,et al: Presurgical visualization of primary breast carcinoma with PET emission and transmission imaging.J Nucl Med 36:1882–1884, 1995.

    PubMed  CAS  Google Scholar 

  23. Scheidhauser K, Scharl A, Pietrzyk U,et al: Qualitative [18F]FDG positron emission tomography in primary breast cancer; Clinical relevance and practicability.Eur J Nucl Med 23:618–623, 1996.

    Article  Google Scholar 

  24. Wahl RL, Zasadny K, Helvie M,et al: Metabolic monitoring of breast cancer chemotherapy using positron emission tomography; Initial evaluation.J Clin Oncol 11:2101–2111, 1993.

    PubMed  CAS  Google Scholar 

  25. Bassa P, Kim EE, Inoue T,et al: Evaluation of preoperative chemotherapy using PET with fluorine-18-fluorodeoxyglucose in breast cancer.J Nucl Med 37:931–938, 1996.

    PubMed  CAS  Google Scholar 

  26. Greco M, Agresti R, Raselli R,et al: Axillary dissection can be avoided in selected breast cancer patients; Analysis of 401 cases.Anticancer Res 16:3913–3918, 1996.

    PubMed  CAS  Google Scholar 

  27. Crippa F, Agresti R, Seregni E,et al: Prospective evaluation of fluorine-18-FDG PET in presurgical staging of axilla in breast cancer.J Nucl Med 39:4–8, 1998.

    PubMed  CAS  Google Scholar 

  28. Utech CI, Young CS, Winter PF,et al: Prospective evaluation of fluorine-18 fluorodeoxyglucose positron emission tomography in breast cancer for staging of the axilla related to surgery and immunocytochem- istry.Eur J Nucl Med 23:1588–1593, 1996.

    Article  PubMed  CAS  Google Scholar 

  29. Avril N, Dose J, Janicke F,et al: Assessment of axillary lymph node involvement in breast cancer patients with positron emission tomography using radiolabeled 2-(Fluorine-18)-fluoro-2-deoxy-D-glu- cose.J Natl Cancer Inst 88:1204–1209, 1996.

    Article  PubMed  CAS  Google Scholar 

  30. Pamilo M, Soiva M, Lavast EM,et al: Realtime ultrasound, axillary mammography, and clinical examination in the detection of axillary lymph node metastases in breast cancer patients.J Ultrasound Med 8:115–120, 1989

    PubMed  CAS  Google Scholar 

  31. Bruneton JN, Caramella E, Aubanel D,et al: Axillary lymph node metastases in breast cancer; Preoperative detection with US.Radiology 158:325–326, 1986

    PubMed  CAS  Google Scholar 

  32. Mustonen P, Farin P, Kosunen O: Ultrasonographic detection of metastatic axillary lymph nodes in breast cancer.Ann Chir Gynecol 79:15–18, 1990.

    CAS  Google Scholar 

  33. Tate JJT, Lewis V, Archer T,et al: Ultrasound detection of axillary lymph node metastases in breast cancer.Eur J Surg Oncol 15:139–141, 1989.

    PubMed  CAS  Google Scholar 

  34. Smith IC, Ogston KN, Whitford P,et al: Staging of the axilla in breast cancer; Accurate in vivo assessment using positron emission tomography with 2-(fluorine-18)-fluoro-2-D-glucose.Ann Surg 2:220–227, 1998.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Tokai University School of Medicine, Japan

    Masatoshi Ohta, Yutaka Tokuda, Yuki Saitoh, Yasuhiro Suzuki, Akira Okumura, Mitsuhiro Kubota, Hiroyasu Makuuchi & Tomoo Tajima

  2. Himedic Imaging Center at Lake Yamanakako, Japan

    Seiei Yasuda & Akira Shohtsu

Authors
  1. Masatoshi Ohta
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  2. Yutaka Tokuda
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  3. Yuki Saitoh
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  4. Yasuhiro Suzuki
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  5. Akira Okumura
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  6. Mitsuhiro Kubota
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  7. Hiroyasu Makuuchi
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  8. Tomoo Tajima
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  9. Seiei Yasuda
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  10. Akira Shohtsu
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Ohta, M., Tokuda, Y., Saitoh, Y. et al. Comparative efficacy of positron emission tomography and ultrasonography in preoperative evaluation of axillary lymph node metastases in breast cancer. Breast Cancer 7, 99–103 (2000). https://doi.org/10.1007/BF02967197

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  • DOI: https://doi.org/10.1007/BF02967197

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