Sentinel Lymph Node Assessment in Breast Cancer Using CT Lymphography in a Community Hospital

Abstract

Computed tomography-lymphography (CTLG) is a beneficial imaging technique for identifying sentinel lymph nodes (SLN) in breast cancer. The study retrospectively reviewed CTLG images obtained preoperatively and analyzed the association between the SLN detection rate and clinicopathological factors. The feasibility of using CTLG for the preoperative prediction of lymph node metastasis in a community hospital setting was also evaluated.

Patient characteristics included an average age of 61.6 ± 12.7 years and body mass index (BMI) of 23.0 ± 3.7 kg/m². The rate of positive lymph node metastasis was 20.2% (N = 76).

The SLN detection rate was 92.2%. Multivariate analysis demonstrated that the SLN detection rate was positively associated with age 62 years or older. BMI less than 23.0 kg/m², and positive hormone receptors. Among patients with severe obesity, the SLN detection rate was as low as 75.0%, suggesting that a review of the CTLG procedure is necessary. Patients with a filling defect had a significantly higher incidence of LN metastases. If a patient with a filling defect was regarded as lymph node metastasis-positive, the negative predictive value was relatively high (85.0%), suggesting that CTLG could be a valuable imaging tool for predicting lymph node metastasis.