open access

Vol 24, No 6 (2019)
Original research articles
Published online: 2019-11-01
Submitted: 2018-07-20
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SPECT-CT localization of axillary sentinel lymph nodes for radiotherapy of early breast cancer

Sergey Novikov, Pavel Krzhivitskii, Sergey Kanaev, Petr Krivorotko, Nikolay Ilin, Julia Melnik, Nadejda Popova
DOI: 10.1016/j.rpor.2019.10.003
·
Rep Pract Oncol Radiother 2019;24(6):688-694.

open access

Vol 24, No 6 (2019)
Original research articles
Published online: 2019-11-01
Submitted: 2018-07-20

Abstract

Purpose

To evaluate the opportunities of single photon emission tomography/computerized tomography (SPECT-CT) for localization of axillary sentinel lymph nodes (ASLNs) and subsequent radiotherapy planning in women with early breast cancer.

Material and methods

Individual topography of ASLN was determined in 151 women with clinical T1-2N0M0 breast cancer. SPECT-CT visualization of ASLNs was initiated 120min after intra-peritumoral injection of 99mTc-radiocolloids. Doses absorbed by virtual ASLNs after the whole breast irradiation with standard and extended tangential fields were calculated on a treatment planning station.

Results

SPECT-CT demonstrated a large variability of ASLN localization. They were detected in the central subgroup in 94 (61%) patients, in pectoral – in 77 (51%), and in interpectoral – in 4 (3%) patients. Sentinel lymph nodes “lying on the chest” were revealed in 35 (23%) cases.

We found that with standard tangential fields coverage of ASLNs was obtained only in 20% of evaluated women. Extended tangential fields can effectively irradiate ASLNs localized in all axillary sub-regions with the exception of ASLNs “lying on the chest”.

Conclusion

SPECT-CT mapping of ASLNs in women with cT1-2N0M0 breast cancer reveals their variable localization. This information can be important for planning of radiation treatment in women that underwent breast conserving surgery without an axillary surgery.

Abstract

Purpose

To evaluate the opportunities of single photon emission tomography/computerized tomography (SPECT-CT) for localization of axillary sentinel lymph nodes (ASLNs) and subsequent radiotherapy planning in women with early breast cancer.

Material and methods

Individual topography of ASLN was determined in 151 women with clinical T1-2N0M0 breast cancer. SPECT-CT visualization of ASLNs was initiated 120min after intra-peritumoral injection of 99mTc-radiocolloids. Doses absorbed by virtual ASLNs after the whole breast irradiation with standard and extended tangential fields were calculated on a treatment planning station.

Results

SPECT-CT demonstrated a large variability of ASLN localization. They were detected in the central subgroup in 94 (61%) patients, in pectoral – in 77 (51%), and in interpectoral – in 4 (3%) patients. Sentinel lymph nodes “lying on the chest” were revealed in 35 (23%) cases.

We found that with standard tangential fields coverage of ASLNs was obtained only in 20% of evaluated women. Extended tangential fields can effectively irradiate ASLNs localized in all axillary sub-regions with the exception of ASLNs “lying on the chest”.

Conclusion

SPECT-CT mapping of ASLNs in women with cT1-2N0M0 breast cancer reveals their variable localization. This information can be important for planning of radiation treatment in women that underwent breast conserving surgery without an axillary surgery.

Get Citation

Keywords

Breast cancer; Sentinel lymph nodes; Radiotherapy; Imaging

About this article
Title

SPECT-CT localization of axillary sentinel lymph nodes for radiotherapy of early breast cancer

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 24, No 6 (2019)

Pages

688-694

Published online

2019-11-01

DOI

10.1016/j.rpor.2019.10.003

Bibliographic record

Rep Pract Oncol Radiother 2019;24(6):688-694.

Keywords

Breast cancer
Sentinel lymph nodes
Radiotherapy
Imaging

Authors

Sergey Novikov
Pavel Krzhivitskii
Sergey Kanaev
Petr Krivorotko
Nikolay Ilin
Julia Melnik
Nadejda Popova

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