THE CLINICAL VALUE OF SPECT/ CT IN IDENTIFYINGSENTINEL LYMPH NODES IN PATIENTS WITH BREASTCANCER: A SYSTEMATIC REVIEW

Introduction: Sentinel lymph node biopsy is an established method used to investigate the riskof lymphatic metastasis especially in breast cancer and melanoma patients. SPECT/ CT isconsidered to be an advantageous method in mapping of sentinel nodes. Aim: The aim of this systematic literature review was to investigate the clinical value ofSPECT/ CT in the detection of sentinel lymph nodes in breast cancer patients. Method: Using specific search terms the database PubMed was used to find studies of potentialrelevance for this systematic review. Criteria for inclusions and exclusion were decided todetermine article relevance. Eligibility of articles was determined according to these criteriawhich lead to the selection of the specific articles included in this study. Results: Eleven studies were included in this systematic review. Seven out of 8 studies foundhigher identification rates of sentinel lymph nodes with SPECT/ CT in comparison to planarlymphoscintigraphy. SPECT/ CT could detect additional lymph nodes in 9 out of 9 studies.SPECT/ CT detected additional extra-axillary lymph nodes in 6 out of 7 studies. SPECT/ CTdetected lymph nodes in 9 out of 9 studies where planar lymphoscintigraphy was negative.Information from additional SPECT/ CT lead to changes in surgical treatment plan in 4 out of4 studies. None of the included studies contained information about change in oncologicaltreatment plan due to findings on SPECT/ CT. Conclusion: SPECT/ CT is an imaging technique with much potential as it seems to allow amore accurate SLN mapping and more precise anatomical localization of SLN in breast cancerpatients, specifically in certain clinical situations. Despite this however, the impact of SLNmapping through SPECT/ CT on patient prognosis remains uncertain