Predication of axillary lymph node metastasis by intravenous digital subtraction angiography in breast cancer, its correlation with microvascular density

Accurate predication of axillary node status by non-invasive diagnostic met hod would be of great value in cases of breast cancer. There have been few reports advocating digital subtraction angiography (DSA) as specifically ad vantageous for the detection of lymph node metastasis. IV (intravenous)-DSA was carried out on 42 patients with breast carcinoma using a DSA system wi th a matrix of 1024 x 1024 pixels. When a mass became stained in the axilla , it was considered to be metastatic. An immunohistochemical technique with JC70 antibody to platelet/endothelial cell adhesion molecules was used to evaluate the microvascular density (MVD) of the axillary lymph nodes. IV-DS A achieved a 76.2% sensitivity, 85.7% specificity, and 81.0% accuracy. The average MVD with JC70 antibody was 97.7 +/- 44.4 in metastatic and 62.9 +/- 23.6 in nonmetastatic nodes. MVD was significantly higher in the cancerous than in the noncancerous regions within lymph nodes. The MVD was 105 +/- 3 8.4 in DSA-N(+) cases and was 57.8 +/- 21.9 in DSA-N(-) cases, and the diff erence was statistically significant. In conclusion, IV-DSA is a useful dia gnostic modality for detection of axillary lymph node metastasis. This new modality predicts lymph node status by assessing the neovascularization of the lymph node.