モリヤ タクヤ   Takuya Moriya
  森谷 卓也
   所属   川崎医科大学  医学部 臨床医学 病理学
   職種   教授
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Preoperative dynamic lymphoscintigraphy predicts sentinel lymph node metastasis in patients with early breast cancer.
掲載誌名 正式名:Breast cancer (Tokyo, Japan)
略  称:Breast Cancer
ISSNコード:13406868/18804233
掲載区分国外
巻・号・頁 17(1),pp.17-21
著者・共著者 Nakashima Kazutaka, Kurebayashi Junichi, Sonoo Hiroshi, Tanaka Katsuhiro, Ikeda Masahiko, Shiiki Shigeo, Yamamoto Yutaka, Nomura Tsunehisa, Sohda Mai, Seki Mari, Miyake Akiko, Moriya Takuya, Sadahira Yoshito, Mimura Hiroaki, Fukunaga Masao
発行年月 2010/01
概要 Background Preoperative lymphoscintigraphy is commonly used in sentinel lymph node biopsy (SLNB) for patients with early breast cancer; however, its significance to predict SLN metastasis remains to be determined.
Patients and methods Sixty patients were enrolled in a feasibility study of SLNB. Patients with clinically node-negative breast cancer were eligible for this study. Dynamic lymphoscintigraphy was performed before SLNB. All patients underwent SLNB followed by axillary lymph node dissection.
Results A dual mapping procedure using isotope and dye injections was performed. SLNs were identified in 59 of 60 patients (98.3%), with a node-positive rate of 41.7% and a false-negative rate of 1.7%. No SLN was identified in 4 of 60 patients (6.7%) on preoperative lymphoscintigraphy. Interestingly, abnormal accumulation of the radiotracer close to hot spots was observed in 29 of 56 patients (51.8%). Lymph node metastases were detected in 18 of 29 patients (62.0%) with this pattern and 5 of 27 patients (18.5%) without this pattern (P < 0.05). Micrometastases were more frequently detected in node-positive patients without this pattern than in those with this pattern (80 vs. 16.7%). Diagnostic parameters of this pattern to predict SLN metastases, including micrometastases, were 62.1% for sensitivity, 81.5% for specificity, and 71.4% for accuracy.
Conclusions Abnormal accumulation of the radiotracer close to radioactive spots may indicate SLN metastasis. When dynamic lymphoscintigraphy shows this pattern, surgeons should consider the presence of SLN metastasis and carefully remove additional lymph nodes surrounding radioactive lymph nodes so as not to leave metastatic SLNs behind.
DOI 10.1007/s12282-009-0123-y
文献番号 19466508