94 [17/18]

100 [5/5]

Numbers in brackets are patient numbers used to derive sensitivity and specificity values.

Numbers in brackets are patient numbers used to derive sensitivity and specificity values.

mean sensitivity and specificity of 61% and 80%, respectively, when at least one focus of abnormal axillary uptake was detected.185

A recent meta-analysis found that FDG-PET has a higher sensitivity for predicting lymph node metastases in the axilla of patients with palpable axillary nodes, 90%, than for those having nonpalpable nodes, 69%, but lower specificity, 88% versus 94%.154 Greco et al.178 showed that in primary breast cancers, the detection rate for axillary nodal disease by FDG-PET depended on the size of the primary lesion, with an overall sensitivity and specificity of 94% and 86%, respectively.

Sentinel lymph node mapping is now a validated, minimally invasive technique that includes histologic analysis of the primary draining nodes in the axilla identified at surgery after perilesional injection of 99mTc-sulfur colloid and/or blue dye.186

FDG-PET has been reported to have a sensitivity in the range of 20% to 50%185-187 in patients with pathologic results from sentinel lymph node (SLN) biopsy. In more advanced disease, however, especially with palpable axillary nodes, a large volume of disease ("packed" SLN) may not be visualized at mapping because lymph flow is diverted around it, and this may potentially result in a false-negative examination.188

Lymphatic spread of tumor to the internal mammary (IM) nodes occurs in up to 25% of patients at the time of initial diagnosis and more commonly in recurrence.189 IM nodes are not as accessible as axillary nodes, and radiotherapy and lymphadenectomy did not seem to improve patient sur-vival.157 For these reasons, they are not sampled, although the presence of IM-FDG uptake predicts treatment failure.

Herbal Remedy Secret Uncovered

Herbal Remedy Secret Uncovered

Discover How To Use Herbal Medicine Effectively To Heal Away Disease amp illnesses That Most Of The Herbalist Do Not Want You To Know About. If You Have Never Know What Is All About Herbal Medicines amp The Correct Way Of Using Herbs To Build A Healthier Life, Then This Guide Is About To Reveal All Just That.

Get My Free Ebook

Post a comment