Axillary Lymph Node Burden in Invasive Breast Cancer: A Comparison of the Predictive Value of Ultrasound-Guided Needle Biopsy and Sentinel Lymph Node Biopsy

Boone, Brian A.; Huynh, Cindy; Spangler, Marion Lee; Sumkin, Jules H.; Johnson, R. R.; McGuire, Kandace P.; Soran, Atilla; Ahrendt, Gretchen

doi:10.1016/j.clbc.2015.03.011

Cited by 30 publications

(14 citation statements)

References 28 publications

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“…According to our results, when US shows probably suspicious ALNs, and the maximum tumor diameter is 24.5 mm or greater, the tumor margin is irregular, and the internal echo is heterogeneous, we would consider these ALNs as ALNM. If required, the diagnosis can be pathologically confirmed via US‐guided FNAB or SNB …”

Section: Discussionmentioning

confidence: 99%

Correlation of Conventional Ultrasound Characteristics of Breast Tumors With Axillary Lymph Node Metastasis and Ki‐67 Expression in Patients With Breast Cancer

Zhang

Sui

Zhou

et al. 2018

J of Ultrasound Medicine

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Objectives-To explore the association between the ultrasound (US) characteristics of breast tumors with axillary lymph node metastasis (ALNM) and Ki-67 expression in patients with breast cancer.Methods-In total, 527 consecutive patients with breast cancer who had undergone US examinations and curative surgery with axillary lymph node evaluations were included. The size, shape, aspect ratio, margin, internal echo, internal calcification, posterior echo attenuation, lymphatic hilar structure, cortical thickness, and blood flow of the axillary lymph nodes or primary breast lesions were observed with conventional US. Pathologic prognostic factors, including the histologic type of the tumor, histologic grade, estrogen and progesterone receptor status, lymph node status, and Ki-67 expression were determined. A logistic regression model was used to evaluate whether the US characteristics of primary breast lesions were associated with ALNM and Ki-67 expression.Results-The maximum tumor diameter (odds ratio [OR], 1.54; 95% confidence interval [CI], 1.05-2.27; P = .028), tumor margin (OR, 2.89; 95% CI, 1.69-4.94; P < .001), internal echo (OR, 2.17; 95% CI, 1.47-3.20; P < .001), and Ki-67 status (OR, 3.57; 95% CI, 2.29-5.58; P < .001) had significant value as independent predictors of ALNM. Only the internal echo (OR, 1.95; 95% CI, 1.28-2.95; P = .002) of breast cancer was an independent predictor of the Ki-67 status. The heterogeneity in the internal echo indicated faster cancer cell proliferation and was associated with a worse prognosis in patients with breast carcinoma.Conclusions-Certain conventional US characteristics may be useful predictors of ALNM and the Ki-67 status in patients with breast cancer.

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Section: Discussionmentioning

confidence: 99%

Correlation of Conventional Ultrasound Characteristics of Breast Tumors With Axillary Lymph Node Metastasis and Ki‐67 Expression in Patients With Breast Cancer

Zhang

Sui

Zhou

et al. 2018

J of Ultrasound Medicine

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“…The National Surgical Adjuvant Breast and Bowel Project (NSABP) trial B-32 showed that overall patient survival, disease-free survival, and regional control were statistically equivalent between the SLN resection plus ALND group and the SLN resection alone group, and which explained that when the SLN is negative, SLN surgery alone with no further ALND is an appropriate, safe, and effective therapy for breast cancer patients with clinically negative lymph nodes (Krag, et al 2010), even in small breast cancers with a diameter ≤2 cm (Veronesi, et al 2003). For comparison of the axillary lymph-node extent between patients with positive nodes determined using ultrasound-guided needle biopsy (USNB) and positive nodes in SLNB, Boone (Boone, et al 2015) demonstrated that breast cancer patients with a positive node detected on ultrasound-guided biopsy have a significantly greater possibility of axillary disease than patients with a positive sentinel lymph node. In any case, ultrasound-detected abnormal lymph nodes can be histologically confirmed by ultrasound-guided biopsy in order to reduce unnecessary sentinel lymph-node biopsy (SLNB) or even axillary lymph-node dissection (ALND) and maximally invasive radical resection (Moorman, et al.…”

Section: Ultrasound and Other Modalities For Lymph-node Diagnosismentioning

confidence: 99%

Ultrasound Imaging Technologies for Breast Cancer Detection and Management: A Review

Guo

Qin

et al. 2018

Ultrasound in Medicine & Biology

329

199

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Ultrasound imaging is a commonly used modality for breast cancer detection and diagnosis. In this review, we summarize ultrasound imaging technologies and their clinical applications for the management of breast cancer patients. The technologies include ultrasound elastography, contrast-enhanced ultrasound, 3-D ultrasound, automatic breast ultrasound and computer-aided detection of breast ultrasound. We summarize the study results seen in the literature and discuss their future directions. We also provide a review of ultrasound-guided, breast biopsy and the fusion of ultrasound with other imaging modalities, especially magnetic resonance imaging (MRI). For comparison, we also discuss the diagnostic performance of mammography, MRI, positron emission tomography and computed tomography for breast cancer diagnosis at the end of this review. New ultrasound imaging techniques, ultrasound-guided biopsy and the fusion of ultrasound with other modalities provide important tools for the management of breast patients.

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“…The condition of Axillary Lymph Nodes (ALN) is the most important prognostic factor in breast cancer and is relevant to the choice of breast cancer treatment tactics [1,2]. There is a strong correlation between the number of damaged axillary lymph nodes and the risk of breast cancer regeneration [3].…”

Section: Introductionmentioning

confidence: 99%

Breast Cancer: The Accuracy of The Paus in Detecting pN2 and Factors that Lead to the True- and False-Negative Results

Artmonienė

Boguševičius

Jonaitienė

et al. 2019

BJSTR

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About 70% of early breast cancer cases axillary lymph nodes are intact and surgical axillary intervention is unnecessary. There is an ongoing search for non-invasive methods to evaluate the status of axillary lymph nodes in order to prevent Axillary Lymph Node Dissection (ALND) or Sentinel Lymph Node Biopsy (SLNB). Patients with normal axillary physical exam and ultrasound rarely harbor a large nodal disease burden (pN2). There are studies suggesting that the Preoperative Axillary Ultrasound (PAUS) can replace SLNB when the axillary surgery is no longer curative and only biomarkers are important for adjuvant chemotherapy. The purpose of this study was to determine the accuracy and reliability of the ultrasound examination in detecting more than three metastatic axillary lymph nodes (pN2) and to assess the clinicopathological factors that lead to the truenegative and false-negative results of the ultrasound study. All patients underwent the PAUS as part of their staging. The nodal status assessed by PAUS was compared with histological findings. Determining pN2, the accuracy of PAUS was 91.2% and the NPV -96.5%. False-negative results of PAUS were 18.7 %. On bivariate analysis, primary Tumor Size (T), the tumor spreading in blood and Lymphatic Vessels (LV), Tumor Grade (G) and patient age were found to be significantly different between true-and false-negative PAUS. We found that PAUS is sufficiently accurate to detect a heavy nodal disease burden and in most cases an additional axillary surgery can be avoided. PAUS findings may be less accurate in young age and in patients with T2, G3 and LV1.

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Axillary Lymph Node Burden in Invasive Breast Cancer: A Comparison of the Predictive Value of Ultrasound-Guided Needle Biopsy and Sentinel Lymph Node Biopsy

Cited by 30 publications

References 28 publications

Correlation of Conventional Ultrasound Characteristics of Breast Tumors With Axillary Lymph Node Metastasis and Ki‐67 Expression in Patients With Breast Cancer

Correlation of Conventional Ultrasound Characteristics of Breast Tumors With Axillary Lymph Node Metastasis and Ki‐67 Expression in Patients With Breast Cancer

Ultrasound Imaging Technologies for Breast Cancer Detection and Management: A Review

Breast Cancer: The Accuracy of The Paus in Detecting pN2 and Factors that Lead to the True- and False-Negative Results

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