Is positron emission tomography an accurate non-invasive alternative to sentinel lymph node biopsy in breast cancer patients?

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.