Application of preoperative computed tomographic lymphography for precise sentinel lymph node biopsy in breast cancer patients

被引:5
作者
Wen, Shishuai [1 ,2 ,3 ]
Liang, Yiran [1 ]
Kong, Xiaoli [1 ]
Liu, Baofeng [4 ]
Ma, Tingting [1 ]
Zhou, Yeqing [1 ]
Jiang, Liyu [1 ]
Li, Xiaoyan [1 ]
Yang, Qifeng [1 ,5 ,6 ]
机构
[1] Shandong Univ, Dept Breast Surg, Gen Surg, Qilu Hosp, Wenhua Xi Rd 107, Jinan 250012, Shandong, Peoples R China
[2] Fudan Univ, Dept Head & Neck Surg, Shanghai Canc Ctr, Shanghai, Peoples R China
[3] Fudan Univ, Shanghai Med Coll, Dept Oncol, Shanghai, Peoples R China
[4] Shandong Univ, Dept Radiol, Qilu Hosp, Jinan, Peoples R China
[5] Shandong Univ, Qilu Hosp, Pathol Tissue Bank, Jinan, Peoples R China
[6] Shandong Univ, Res Inst Breast Canc, Jinan, Peoples R China
基金
中国国家自然科学基金;
关键词
Sentinel lymph node biopsy; Preoperative SLNs and lymphatics localization; Computed tomographic lymphography; CT three-dimensional reconstruction; CORE NEEDLE-BIOPSY; AXILLARY DISSECTION; PRACTICE GUIDELINE; AMERICAN-SOCIETY; LOCAL RECURRENCE; MORBIDITY; LOCALIZATION; ASPIRATION; STAGE; EXPERIENCE;
D O I
10.1186/s12893-021-01190-7
中图分类号
R61 [外科手术学];
学科分类号
摘要
BackgroundIn 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.MethodsTwenty-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.ResultsSLNs 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%.ConclusionWe 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.
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页数:8
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