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FDG-PET WITH SENTINEL LYMPH NODE BIOPSY FOR EVALUATION OF AXİLLARY INVOLVEMENT IN BREAST CANCER. Semih Gorgulu, MD Gulhane Military Medical Academy, Dept. of Surgery Ankara, TURKEY. Breast Cancer. Jemal, A et al CA Cancer J Clin 2006;56:106-130.
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FDG-PET WITH SENTINEL LYMPH NODE BIOPSY FOR EVALUATION OF AXİLLARY INVOLVEMENT IN BREAST CANCER Semih Gorgulu, MD Gulhane Military Medical Academy, Dept. of Surgery Ankara, TURKEY
Breast Cancer Jemal, A et al CA Cancer J Clin 2006;56:106-130
The single most powerful independent predictor of recurrence and survival Provides staging & prognostic information Significant short&longterm sequelae Lymheodema Restriction of arm and shoulder movement Numbness of upper arm skin The best procedure examining the axillary lymph nodes is still standard axillary lymph node dissection and pathological node examination Clinical examination and currently available imaging techniques are inaccurate for axillary staging
Axillary staging through a minimally invasive and less morbid surgical approach More precise and consistent identification of the node with highest pathological yield But still involves a surgical procedure A reliable axillary staging technique, although a limited number of false negative results are a feature of all published experience
Positron Emission Tomography (PET) Nuclear medicine imaging modality Biochemical & physiologic activity Anatomic image Malignant cells exhibit increased glycolitic activity Radio labeled glucose analog [F-18] Fluorodeoxyglucose (FDG)
Analyze the value of FDG PET scanning in detecting axillary lymph node involvement in women with primary breast cancer undergoing sentinel lymph node (SN) biopsy 24 women with newly diagnosed invasive breast cancer underwent FDG-PET. İmages were blindly interpreted by two experienced readers for abnormally increased axillary FDG uptake. After SN biopsy all patients underwent complete axillary lymph node dissection
CONCLUSIONS After the promising initial results, more recent studies showed that FDG-PET is not yet sufficiently sensitive in detection of lymph node metastases This limitation has become particularly clear since the introduction of aggressive pathological examination Currently FDG-PET cannot be routinely used for axillary staging of operable breast cancer
Gulhane Military Medical Academy Ankara TURKEY