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ナカシマ カズタカ
Kazutaka Nakashima
中島 一毅 所属 川崎医科大学 医学部 臨床医学 総合外科学 職種 特任教授 |
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| 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 |
| 担当区分 | 筆頭著者,責任著者 |
| 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 |