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Clinical Utility of Sentinel Lymph Node Biopsy Using the Medical Imaging Projection System in Breast Cancer Patients,
Aoi Oshiro1, Masayuki Nagahashi2, Yusa Togashi1
1Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan.
Background/Aim:
The Medical Imaging Projection System (MIPS) is a real-time projection mapping system with a highly sensitive fluorescence sensing system. The aim of this study was to investigate the clinical utility of sentinel lymph node (SLN) biopsy using MIPS and radioisotopes (RI) in patients with breast cancer including those who had undergone neoadjuvant chemotherapy (NAC).
Patients And Methods:
This retrospective observational study included patients with breast cancer who underwent SLN biopsy using both MIPS and RI at Hyogo Medical University Hospital from August 2023 to August 2024.
Results:
In all, 151 patients with breast cancer (157 axillary lesions, considering bilateral cancer as two lesions) were included in this study. MIPS identified significantly more SLNs than RI (median, 2 vs. 1, p<0.001). MIPS alone identified SLNs in 96.2% of lesions, and when combined with RI, identified SLNs in 99.4% of lesions, including in patients who had undergone NAC. Eleven of 157 lesions (7.0%) had positive SLNs, and the combination method identified positive nodes in 10 of these 11 lesions (90.9%). Importantly, all five lesions with metastases after NAC were observed in patients with cN1/ycN0 disease and the luminal subtype.
Conclusion:
MIPS combined with RI achieves a high identification rate of SLNs in patients with breast cancer, including those who had undergone NAC. Patients with cN1 disease prior to NAC should undergo axillary surgery tailored to their characteristics.
