The added value of positron emission mammography in the assessment of the axillary lymph nodes of the pathologically proven breast cancer

Abstract

Abstract Background The staging and management of patients with breast cancer are significantly influenced by the pathological state of the axillary lymph nodes (ALN). Thus, it is very desirable to have a differential diagnosis of metastatic ALN. Purpose The aim of this research is to assess the effectiveness of non-invasive ALN staging using PEM versus traditional breast mammography and ultrasound in patients presenting with early-stage breast cancer. This study focuses on determining if PEM can reliably stage ALNs and potentially eliminate the need for more invasive methods. Methods In a study involving 94 breast cancer patients, PEM was used to assess ALNs. The nodes were visually evaluated for positive or negative uptake, and further categorized as non-specific, indeterminate, or malignant based on their maximum uptake values. This classification was then compared with histopathological results. Results There were a total of 94 breast cancer patients; the results from PEM demonstrated an ALN detection sensitivity of 83.3%. The specificity of PEM in this context was found to be 98.08%, and the overall accuracy rate was 91.49%. Additionally, the Positive Predictive Value (PPV) was calculated to be 97.2%, and the Negative Predictive Value (NPV) was 87.9%. Conclusions The initial study has shown encouraging outcomes in terms of accurate lymph node assessment.

Keywords

• Positron emission mammography (PEM)
• Axillary lymph nodes
• Breast cancer
• PUVmax