{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T15:00:50Z","timestamp":1722351650444},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,2,5]],"date-time":"2022-02-05T00:00:00Z","timestamp":1644019200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,2,5]],"date-time":"2022-02-05T00:00:00Z","timestamp":1644019200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Radiat Oncol"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Current literature lacks a comparison of lymph node metastases and non-pathological lymph nodes distribution in breast cancer patients. The aim of the current retrospective study was to generate a comprehensive atlas of the lymph node system.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>143 breast cancer patients underwent F-18-FDG-PET\/CT (PET\/CT) imaging for staging purposes and were diagnosed with regional lymph node metastases. Based on the PET\/CT data set a total of 326 lymph node metastases and 1826 non-pathological lymph nodes were detected and contoured manually in the patient collective. Using rigid and deformable registration algorithms all structures were transferred to a template planning CT of a standard patient. Subsequently, a 3D-atlas of the distribution of lymph node metastases and non-pathological lymph nodes were generated and compared to each other.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Both, lymph node metastases and non-pathological lymph nodes, accumulated in certain areas (\u201chot-spots\u201d) within the lymphatic drainage system. However large differences regarding the distribution patterns were detected: lymph node metastases hot spots occurred in close proximity to the subclavian vein in level I-III, whereas the non-pathological lymph nodes accumulated mostly (within a wider range) in level I. In level II and III lymph node metastases exceeded clearly the areas in which non-pathological lymph nodes occurred.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Lymph node metastases and non-pathological lymph node distribution within the lymph node system differ clearly. Based on our results, an individual adjustment of the CTV in order to include visible lymph nodes in level II and III should be discussed.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13014-021-01964-6","type":"journal-article","created":{"date-parts":[[2022,2,5]],"date-time":"2022-02-05T20:02:43Z","timestamp":1644091363000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of the distribution of lymph node metastases compared to healthy lymph nodes in breast cancer"],"prefix":"10.1186","volume":"17","author":[{"given":"Kai J.","family":"Borm","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia","family":"Ernst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Voppichler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Oechsner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathias","family":"D\u00fcsberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Buschner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Weber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie E.","family":"Combs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marciana N.","family":"Duma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,2,5]]},"reference":[{"key":"1964_CR1","doi-asserted-by":"publisher","unstructured":"Early Breast Cancer Trialists\u2019 Collaborative Group. Multi-agent chemotherapy for early breast cancer. Cochrane Database Syst Rev. 2002;(1):CD000487. https:\/\/doi.org\/10.1002\/14651858.CD000487. Update in: Cochrane Database Syst Rev. 2008;(4):CD000487. PMID: 11869577.","DOI":"10.1002\/14651858.CD000487"},{"issue":"9814","key":"1964_CR2","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1016\/S0140-6736(11)61625-5","volume":"379","author":"R Peto","year":"2012","unstructured":"Group EBCTC, Peto R, Davies C, et al. Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials. Lancet. 2012;379(9814):432\u201344.","journal-title":"Lancet"},{"key":"1964_CR3","unstructured":"Network. NCC. Breast Cancer- Version 3.2020. https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/breast.pdf. Accessed 13 Mar 2020."},{"issue":"4","key":"1964_CR4","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1056\/NEJMoa1415340","volume":"373","author":"TJ Whelan","year":"2015","unstructured":"Whelan TJ, Olivotto IA, Parulekar WR, et al. Regional nodal irradiation in early-stage breast cancer. N Engl J Med. 2015;373(4):307\u201316.","journal-title":"N Engl J Med"},{"issue":"4","key":"1964_CR5","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1056\/NEJMoa1415369","volume":"373","author":"PM Poortmans","year":"2015","unstructured":"Poortmans PM, Collette S, Kirkove C, et al. Internal mammary and medial supraclavicular irradiation in breast cancer. N Engl J Med. 2015;373(4):317\u201327.","journal-title":"N Engl J Med"},{"key":"1964_CR6","first-page":"CD004561","volume":"1","author":"N Bromham","year":"2017","unstructured":"Bromham N, Schmidt-Hansen M, Astin M, Hasler E, Reed MW. Axillary treatment for operable primary breast cancer. Cochrane Database Syst Rev. 2017;1:CD004561.","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"1964_CR7","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1002\/jso.20061","volume":"87","author":"M Schaapveld","year":"2004","unstructured":"Schaapveld M, Otter R, de Vries EG, et al. Variability in axillary lymph node dissection for breast cancer. J Surg Oncol. 2004;87(1):4\u201312.","journal-title":"J Surg Oncol"},{"issue":"1","key":"1964_CR8","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1186\/s13063-018-3021-9","volume":"19","author":"G Henke","year":"2018","unstructured":"Henke G, Knauer M, Ribi K, et al. Tailored axillary surgery with or without axillary lymph node dissection followed by radiotherapy in patients with clinically node-positive breast cancer (TAXIS): study protocol for a multicenter, randomized phase-III trial. Trials. 2018;19(1):667.","journal-title":"Trials"},{"key":"1964_CR9","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1016\/j.clbc.2019.01.013","volume":"19","author":"I Natsiopoulos","year":"2019","unstructured":"Natsiopoulos I, Intzes S, Liappis T, et al. Axillary lymph node tattooing and targeted axillary dissection in breast cancer patients who presented as cN+ before neoadjuvant chemotherapy and became cN0 after treatment. Clin Breast Cancer. 2019;19:208\u201315.","journal-title":"Clin Breast Cancer"},{"issue":"1","key":"1964_CR10","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1016\/j.radonc.2015.12.027","volume":"118","author":"BV Offersen","year":"2016","unstructured":"Offersen BV, Boersma LJ, Kirkove C, et al. ESTRO consensus guideline on target volume delineation for elective radiation therapy of early stage breast cancer, version 1.1. Radiother Oncol. 2016;118(1):205\u20138.","journal-title":"Radiother Oncol"},{"key":"1964_CR11","unstructured":"RTOG. Breast Cancer Atlas for Radiation Therapy Planning. https:\/\/www.rtog.org\/LinkClick.aspx?fileticket=vzJFhPaBipE%3d&tabid=236. Accessed 21 June 2020."},{"issue":"21","key":"1964_CR12","doi-asserted-by":"publisher","first-page":"4357","DOI":"10.1200\/JCO.2004.08.120","volume":"22","author":"G Antoch","year":"2004","unstructured":"Antoch G, Saoudi N, Kuehl H, et al. Accuracy of whole-body dual-modality fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography and computed tomography (FDG-PET\/CT) for tumor staging in solid tumors: comparison with CT and PET. J Clin Oncol. 2004;22(21):4357\u201368.","journal-title":"J Clin Oncol"},{"issue":"10","key":"1964_CR13","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1258\/ar.2012.110635","volume":"53","author":"C Riegger","year":"2012","unstructured":"Riegger C, Koeninger A, Hartung V, et al. Comparison of the diagnostic value of FDG-PET\/CT and axillary ultrasound for the detection of lymph node metastases in breast cancer patients. Acta Radiol. 2012;53(10):1092\u20138.","journal-title":"Acta Radiol"},{"issue":"8","key":"1964_CR14","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1177\/0284185114539786","volume":"56","author":"N Ergul","year":"2015","unstructured":"Ergul N, Kadioglu H, Yildiz S, et al. Assessment of multifocality and axillary nodal involvement in early-stage breast cancer patients using 18F-FDG PET\/CT compared to contrast-enhanced and diffusion-weighted magnetic resonance imaging and sentinel node biopsy. Acta Radiol. 2015;56(8):917\u201323.","journal-title":"Acta Radiol"},{"key":"1964_CR15","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1016\/j.ijrobp.2018.07.2025","volume":"103","author":"KJ Borm","year":"2018","unstructured":"Borm KJ, Voppichler J, Dusberg M, et al. FDG\/PET-CT based lymph node atlas in breast cancer patients. Int J Radiat Oncol Biol Phys. 2018;103:574\u201382.","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"10","key":"1964_CR16","doi-asserted-by":"publisher","first-page":"1543","DOI":"10.1007\/s00259-009-1145-6","volume":"36","author":"TA Heusner","year":"2009","unstructured":"Heusner TA, Kuemmel S, Hahn S, et al. Diagnostic value of full-dose FDG PET\/CT for axillary lymph node staging in breast cancer patients. Eur J Nucl Med Mol Imaging. 2009;36(10):1543\u201350.","journal-title":"Eur J Nucl Med Mol Imaging"},{"issue":"1","key":"1964_CR17","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.radonc.2016.10.016","volume":"122","author":"JS Chang","year":"2017","unstructured":"Chang JS, Byun HK, Kim JW, et al. Three-dimensional analysis of patterns of locoregional recurrence after treatment in breast cancer patients: validation of the ESTRO consensus guideline on target volume. Radiother Oncol. 2017;122(1):24\u20139.","journal-title":"Radiother Oncol"},{"issue":"1","key":"1964_CR18","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/j.radonc.2017.09.031","volume":"126","author":"JS Chang","year":"2018","unstructured":"Chang JS, Lee J, Chun M, et al. Mapping patterns of locoregional recurrence following contemporary treatment with radiation therapy for breast cancer: a multi-institutional validation study of the ESTRO consensus guideline on clinical target volume. Radiother Oncol. 2018;126(1):139\u201347.","journal-title":"Radiother Oncol"},{"issue":"2","key":"1964_CR19","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1016\/j.ijrobp.2015.07.002","volume":"93","author":"MS Gentile","year":"2015","unstructured":"Gentile MS, Usman AA, Neuschler EI, Sathiaseelan V, Hayes JP, Small W Jr. Contouring guidelines for the axillary lymph nodes for the delivery of radiation therapy in breast cancer: evaluation of the RTOG breast cancer atlas. Int J Radiat Oncol Biol Phys. 2015;93(2):257\u201365.","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"4","key":"1964_CR20","doi-asserted-by":"publisher","first-page":"1098","DOI":"10.1016\/j.ijrobp.2009.06.002","volume":"77","author":"SM MacDonald","year":"2010","unstructured":"MacDonald SM, Harisinghani MG, Katkar A, Napolitano B, Wolfgang J, Taghian AG. Nanoparticle-enhanced MRI to evaluate radiation delivery to the regional lymphatics for patients with breast cancer. Int J Radiat Oncol Biol Phys. 2010;77(4):1098\u2013104.","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"2","key":"1964_CR21","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1002\/cncr.11464","volume":"98","author":"SD Nathanson","year":"2003","unstructured":"Nathanson SD. Insights into the mechanisms of lymph node metastasis. Cancer. 2003;98(2):413\u201323.","journal-title":"Cancer"},{"key":"1964_CR22","doi-asserted-by":"publisher","first-page":"36","DOI":"10.3389\/fonc.2018.00036","volume":"8","author":"D Jones","year":"2018","unstructured":"Jones D, Pereira ER, Padera TP. Growth and immune evasion of lymph node metastasis. Front Oncol. 2018;8:36.","journal-title":"Front Oncol"},{"issue":"1","key":"1964_CR23","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.radonc.2014.11.030","volume":"114","author":"BV Offersen","year":"2015","unstructured":"Offersen BV, Boersma LJ, Kirkove C, et al. ESTRO consensus guideline on target volume delineation for elective radiation therapy of early stage breast cancer. Radiother Oncol. 2015;114(1):3\u201310.","journal-title":"Radiother Oncol"}],"container-title":["Radiation Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13014-021-01964-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13014-021-01964-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13014-021-01964-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,16]],"date-time":"2022-05-16T16:11:53Z","timestamp":1652717513000},"score":1,"resource":{"primary":{"URL":"https:\/\/ro-journal.biomedcentral.com\/articles\/10.1186\/s13014-021-01964-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,5]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["1964"],"URL":"https:\/\/doi.org\/10.1186\/s13014-021-01964-6","relation":{},"ISSN":["1748-717X"],"issn-type":[{"value":"1748-717X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,5]]},"assertion":[{"value":"9 April 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 December 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 February 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 May 2022","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Update","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"After publication of the original article, it was noted that the Open Access funding information was missing from this article and should have read \u2018Open Access funding enabled and organized by Projekt DEAL\u2019.","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Ethic committee of the Technical University Munich (553\/19 S) has approved this retrospective study. All patients gave their informed consent for radiotherapy. The need for a second informed consent for his retrospective study was deemed unnecessary.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethic approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"27"}}