Anatomical classification of breast sentinel lymph nodes using computed tomography-lymphography

Area of Science:

• Oncology
• Radiology
• Anatomy

Background:

• Sentinel lymph node biopsy is standard for staging breast cancer.
• Accurate anatomical classification of sentinel lymph nodes aids surgical planning.
• Preoperative imaging can improve the identification and biopsy of sentinel lymph nodes.

Purpose of the Study:

• To evaluate the anatomical classification and location of breast sentinel lymph nodes using preoperative computed tomography-lymphography (CT-L).
• To assess the clinical importance of understanding lymphatic and sentinel lymph node morphology for breast cancer treatment.

Main Methods:

• Retrospective review of 464 cases of clinically node-negative breast cancer patients who underwent CT-L between July 2007 and June 2016.
• Anatomical classification based on lymphatic route number, sentinel lymph node number, flow direction, and location.
• Analysis of CT-L findings for variations in lymphatic pathways and sentinel lymph node characteristics.

Main Results:

• Anatomical classification was feasible in 93.5% of cases (434/464).
• The most common pattern was a single route with a single sentinel lymph node (68.2%).
• Outward lymphatic flow towards axillary nodes was observed in 98.8% of cases, with 74.4% located in the upper pectoral group.

Conclusions:

• Computed tomography-lymphography is a suitable imaging modality for preoperative assessment of breast sentinel lymph node anatomy.
• Significant variations exist in lymphatic route patterns and sentinel lymph node characteristics.
• Preoperative understanding of anatomical morphology is clinically important for optimizing breast cancer treatment.