Early results with ferumoxtran-10 MRI in breast cancer show a sensitivity of 78%, a specificity of 96% and a negative predictive value of 97% (Figure 3.4) (Michel et al. 2002). The sentinel lymph node procedure in breast cancer has a 3% to 10% false negative rate; furthermore, positive internal mammary lymph nodes are missed in 17%. Finally, the sentinel lymph node is the only positive node in 61% lymph node positive patients. These patients all undergo axillary dissection, with subsequent high rate of clinically significant lymph edema. As a result from its high negative predictive value, in patients with a negative ferumoxtran-10 MRI, axillary dissection may potentially be avoided. Further studies are under its way to validate this statement.
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