In summary, based on the present literature (14-16) and on own experience (13), we suggest that PET scanning does not currently have the adequate spatial resolution to detect both micro- and small macro-metastatic disease in axillary lymph nodes of patients with breast cancer. Therefore, PET scanning cannot serve at this time as a non-invasive alternative to SLN biopsy. It is possible, however, that with the advent of new detector materials in clinical practice (e.g., lithium, silicon, curved crystals), the sensitivity of 18F-FDG-PET will further improve (35) and could eventually replace invasive procedures in the evaluation of the nodal status of patients with breast cancer.
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Guller, U., Nitzsche, E., Moch, H., & Zuber, M. (2003). Is positron emission tomography an accurate non-invasive alternative to sentinel lymph node biopsy in breast cancer patients? Journal of the National Cancer Institute, 95(14), 1040–1043. https://doi.org/10.1093/jnci/95.14.1040