Comparison of 3D-CT Lymphography Images before and after Neoadjuvant Chemotherapy for Breast Cancer

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  • KONDO Ryoichi
    Department of Surgery, Koyama Memorial Hospital Department of Breast Surgery, Tokyo Medical University Ibaraki Medical Center
  • FUJITA Tomoyuki
    Department of Breast Surgery, Tokyo Medical University Ibaraki Medical Center
  • NISHIMURA Hajime
    Department of Breast Surgery, Tokyo Medical University Ibaraki Medical Center
  • KAMEDA Noriaki
    Chiba Cytopathology Diagnostic Center
  • FUJIMORI Minoru
    Department of Breast Surgery, Tokyo Medical University Ibaraki Medical Center

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Other Title
  • 乳癌術前化学療法施行症例におけるセンチネルリンパ節3D-CTLG画像の検討
  • 臨床経験 乳癌術前化学療法施行症例におけるセンチネルリンパ節3D-CTLG画像の検討
  • リンショウ ケイケン ニュウガン ジュツゼン カガク リョウホウ シコウ ショウレイ ニ オケル センチネルリンパセツ 3D-CTLG ガゾウ ノ ケントウ

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Abstract

The sentinel lymph node biopsy (SNB) has not been established in patients with breast cancer performed neoadjuvant chemotherapy. We comparatively studied changes in the lymphatic flow and those in visualized images of sentinel lymph node (SN) before and after neoadjuvnat chemotherapy by using 3D-CT lymphography (LG). Subjects : We enrolled a total of 12 patients who underwent neoadjuvant chemotherapy and gained a PR of higher and whose tumors were diagnosed as N0 based on imaging findings and CT-guided fine needle aspiration cytology (FNA) of sentinel lymph node. Methods : After infusing 2.5 cc each of Omnipaque® to right above the tumor and into the intracutaneous structure of the areola, we performed 3D-CTLG. At the same time, we conducted CT-guided SN/FNA before the chemotherapy. Results : Superposing of images taken before and after the chemotherapy disclosed complete consistency of 3D-CTLG images. During surgery, SNB using methylene blue dye was performed in all cases, but metastasis to SN was not been proved by intraoperative frozen section diagnosis that was compatible with the result of N0 that was diagnosed before chemotherapy. Conclusion : There were no changes in 3D-CTLG images before and after chemotherapy, and we consider that the same SNB as performed in non-neoadjuvant chemotherapy cases could be done in neoadjuvant cases, as long as they are of N0 cases.

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