3-Dimensional Computed Tomography Lymphography–Guided Identification of Sentinel Lymph Nodes in Breast Cancer Patients Using Subcutaneous Injection of Nonionic Contrast Medium

Minato, M.; Hirose, Chieko; Sasa, Mitsunori; Nishitani, Hiromu; Hirose, Yukiko; Morimoto, Takahiro

doi:10.1097/00004728-200401000-00007

Cited by 41 publications

(23 citation statements)

References 23 publications

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Section: Discussionmentioning

confidence: 99%

“…The most commonly used methods for identifying the SLN are the dye-staining method [2, 3] and the radioisotope method [4,5]. We used multidetector-row, three-dimensional computed tomographic (3D-CT) lymphography to mark the precise location of the SLN on the skin before the operation [6][7][8].We have devised a new endoscopic surgical procedure for breast diseases, video-assisted breast surgery (VABS), which has been previously reported [9]. The VABS procedure has three main features: (1) working space is created by the retraction method; (2) almost all surgical procedures are performed through a small axillary or periareolar incisional port; and (3) the breast is reconstructed simultaneously to preserve the preoperative breast shape.…”

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confidence: 99%

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Video-assisted breast surgery and sentinel lymph node biopsy guided by three-dimensional computed tomographic lymphography

Yamashita

Shimizu

2007

Surg Endosc

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Video-assisted breast surgery and sentinel lymph node biopsy guided by three-dimensional computed tomographic lymphography

Yamashita

Shimizu

2007

Surg Endosc

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“…LS). Minato et al were also able to predict SNs in 13/15 patients with breast cancer, either by enhancement of the lymphatic vessel draining into the SN, or enhancement in the SN itself, correlating well with blue-dye detection (50). Suga et al have also demonstrated CT detection of SNs in esophageal cancer (51).…”

Section: Computed Tomographymentioning

confidence: 93%

Imaging of the lymphatic system: new horizons

Barrett

Choyke

Kobayashi

2006

Contrast Media Mol Imaging

133

125

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The lymphatic system is a complex network of lymph vessels, lymphatic organs and lymph nodes. Traditionally, imaging of the lymphatic system has been based on conventional imaging methods like computed tomography (CT) and magnetic resonance imaging (MRI), whereby enlargement of lymph nodes is considered the primary diagnostic criterion for disease. This is particularly true in oncology, where nodal enlargement can be indicative of nodal metastases or lymphoma. CT and MRI on their own are, however, anatomical imaging methods. Newer imaging methods such as positron emission tomography (PET), dynamic contrast-enhanced MRI (DCE-MRI) and color Doppler ultrasound (CDUS) provide a functional assessment of node status. None of these techniques is capable of detecting flow within the lymphatics and, thus, several intra-lymphatic imaging methods have been developed. Direct lymphangiography is an all-but-extinct method of visualizing the lymphatic drainage from an extremity using oil-based iodine contrast agents. More recently, interstitially injected intra-lymphatic imaging, such as lymphoscintigraphy, has been used for lymphedema assessment and sentinel node detection. Nevertheless, radionuclide-based imaging has the disadvantage of poor resolution. This has lead to the development of novel systemic and interstitial imaging techniques which are minimally invasive and have the potential to provide both structural and functional information; this is a particular advantage for cancer imaging, where anatomical depiction alone often provides insufficient information. At present the respective role each modality plays remains to be determined. Indeed, multi-modal imaging may be more appropriate for certain lymphatic disorders. The field of lymphatic imaging is ever evolving, and technological advances, combined with the development of new contrast agents, continue to improve diagnostic accuracy.

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“…We identified the SN using CT-lymphography (CTLG) combined with dye-staining [9,10] because our institution is not equipped with RI facilities. Clinicopathological studies to determine the metastatic status of SNs were performed on 2-mm sections of hematoxylin-eosin (HE)-stained surgical permanent specimens.…”

Section: Methodsmentioning

confidence: 99%

Early Results of Omitting Completion Axillary Lymph Node Dissection in Sentinel Lymph Node Metastasis-Positive Breast Cancer Patients

Honda¹,

Matsuoka²,

Hirose³

et al. 2013

ABCR

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Background: We investigated the early results of omitting completion axillary lymph node dissection (ALND) for axillary node metastasis-negative (N0), sentinel node (SN) metastasis-positive breast cancer patients. Patients and Methods: 489 patients had invasive N0 breast cancer treated without completion ALND, regardless of their SN metastasis status. Analyses included the associations between the SN metastasis status, clinicopathological findings and recurrence, between recurrence and clinicopathological findings, and recurrence-free survival. Results: 430 patients were SN biopsy (SNB)-negative, and 59 were SNB-positive. The SNB-positive patients received significantly more potent adjuvant therapy than the SNB-negative patients. Median follow-up was 3.7 years, and the axillary node recurrence was seen in 6 patients (1.2%) and recurrence in 21 patients. The SN status showed no associations with the clinicopathological findings or recurrence. Univariate analysis showed recurrence was associated with absence of hormonal therapy, ER-negative, PgR-negative, HER2-positive or triple-negative (TNBC) disease, a tumor ≥2.1 cm and higher nuclear grade. Multivariate analysis showed recurrence was associated with absence of hormonal therapy and a tumor ≥2.1 cm. Cox proportional hazards model showed recurrence was extremely early in ER-negative and TNBC patients. Conclusion: Completion ALND can be skipped in N0 breast cancer patients even if they are SNB-positive, but adjuvant therapy is essential.

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3-Dimensional Computed Tomography Lymphography–Guided Identification of Sentinel Lymph Nodes in Breast Cancer Patients Using Subcutaneous Injection of Nonionic Contrast Medium

Cited by 41 publications

References 23 publications

Video-assisted breast surgery and sentinel lymph node biopsy guided by three-dimensional computed tomographic lymphography

Video-assisted breast surgery and sentinel lymph node biopsy guided by three-dimensional computed tomographic lymphography

Imaging of the lymphatic system: new horizons

Early Results of Omitting Completion Axillary Lymph Node Dissection in Sentinel Lymph Node Metastasis-Positive Breast Cancer Patients

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