Imaging technique helps predict breast cancer spread before surgery

h nodes. Using this threshold, the scans were 72 percent accurate; had a sensitivity of 60 percent, meaning that 60 percent of those with axillary metastases were identified; a specificity of 100 percent, meaning that no one without metastases was identified as having metastases; and a positive predictive value--or proportion of patients with a positive result who are accurately diagnosed--of 100 percent.

Physicians should not necessarily replace other methods with PET scans, but if the scans are already performed before surgery, calculating a standard update value for axillary activity will help them determine if the lymph nodes are involved, the authors write. Technical and calibration factors cause variations in readings, therefore, "each PET center needs to develop its reference values," they continue. "However, if a PET standardized uptake value is validated and can predict node positivity with 100 percent specificity, chemotherapy can be initiated or a surgeon can proceed directly to axillary lymph node dissection for locoregional control."
(Arch Surg. 2006;141:783-789. Available pre-embargo to the media at http://www.jamamedia.org.)


Contact: Sandy Van
JAMA and Archives Journals

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