Video-assisted breast surgery and sentinel lymph node biopsy guided by three-dimensional computed tomographic...

Area of Science:

• Oncology
• Surgical Innovation
• Medical Imaging

Background:

• Video-assisted breast surgery (VABS) offers improved aesthetics and reduced invasiveness for various breast conditions.
• VABS is increasingly utilized for benign and malignant diseases, as well as sentinel lymph node biopsy (SLNB).
• The study evaluates the efficacy of 3D-CT lymphography in conjunction with VABS.

Purpose of the Study:

• To assess the precision of 3D-CT lymphography in identifying sentinel lymph nodes (SLNs) during VABS.
• To evaluate the cosmetic and therapeutic outcomes of VABS procedures.
• To determine the utility of 3D-CT lymphography for guiding SLNB within VABS.

Main Methods:

• VABS performed via a small incision (2.5 cm, or 1 cm for SLNB) using retraction.
• 3D-CT lymphography conducted the day prior to surgery, injecting contrast near the tumor/areola.
• Image reconstruction produced 3D visualizations for precise SLN marking and biopsy guidance.

Main Results:

• VABS was performed for 150 patients (19 benign, 131 malignant diseases).
• 115 SLNBs were performed, 74 utilizing 3D-CT lymphography.
• 3D-CT lymphography accurately depicted SLNs and their lymphatic pathways, crucial for metastasis assessment.

Conclusions:

• 3D-CT lymphography is a valuable tool for precise sentinel lymph node biopsy (SLNB) within video-assisted breast surgery (VABS).
• The combined approach enhances the safety and minimally invasive nature of SLNB.
• Accurate SLN identification via 3D-CT lymphography supports oncologic treatment planning.