CT findings of breast cancer with clinically complete response following neoadjuvant chemotherapy - histological correlation

Ogawa, Yasuhiro; Nishioka, Akihito; Kubota, Kei; Kariya, Shuji; Shoji, Yasuhiro; Maeda, Hironori; Tanaka, Yosuke; Moriki, Toshiaki; Tochika, Naoshige

doi:10.3892/or.10.5.1411

Cited by 5 publications

(5 citation statements)

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“…The potential contributions of CT in this indication are summarized in Table 2 (7,11–37). In despite of its high sensitivity and its good spatial resolution (7,11–37), CT remains an under‐used and under‐estimated tool in breast diseases. Because of its availability and its high performances, CT is often used in our hospital instead of MR imaging for a suspicion of recurrence (1,30) and a preoperative assessment of a breast cancer.…”

Section: Discussionmentioning

confidence: 99%

Computed Tomography-Guided Localization of Breast Lesions

Murgo¹,

Wyshoff²,

Faverly³

et al. 2008

Breast Journal

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Magnetic resonance (MR) imaging and computed tomography (CT) of the breast allow the detection of breast lesions occult on physical examination, mammography and ultrasound. We report our experience to localize such lesions under CT-guidance. 30 patients underwent 30 CT-guided preoperative localizations of breast lesions using a sequential technique or a continuous imaging. All these lesions were initially detected by MR (n = 11) and/or CT (n = 19) and were occult for all the other techniques. In eight patients with a superficial and/or internal lesion, a skin location using a painting pen was performed. In the 23 other cases, the extremity of a hookwire was placed into the lesion or within 5 mm surrounding the target. All the lesions were localized with success under CT-guidance. The pathological analysis of the surgical specimens concluded in 11 breast cancers, four lesions of uncertain malignancy potential and 15 benign lesions. The size of these lesions ranged from 4 to 28 mm (mean: 10 mm). No significant complication related to the procedure was observed. Localization under CT guidance is a safe and effective technique to guide the surgical biopsy of breast lesions that can be seen solely on MR or CT.

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Section: Discussionmentioning

confidence: 99%

Computed Tomography-Guided Localization of Breast Lesions

Murgo¹,

Wyshoff²,

Faverly³

et al. 2008

Breast Journal

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“…Localization of breast lesion (11) especially detected by MRI (7,12). Prediction of residual breast cancer after neoadjuvant chemotherapy (13)(14)(15)(16)(17)(18)(19). Metastatic axillary lymph nodes of unknown origin (20).…”

Section: Discussionmentioning

confidence: 99%

Computed tomography-guided localization of breast lesions

Murgo¹,

Wyshoff²,

Faverly³

et al. 2008

Clinical Imaging

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“…NAC was performed preoperatively and consisted of three to four times of CAF chemotherapy (each chemotherapy administration consisted of 600 mg/m 2 of cyclophosphamide, 600 mg/m 2 of 5-fluorouracil, and 20-40 mg/body of pirarubicin, every two weeks) (2). The number of NAC administrations was decided according to the effect of NAC on the shrinkage of the main breast tumor and metastatic lymph nodes (2). Moreover, the intraarterial (subclavian artery and internal mammary artery) infusion of epirubicin (40 mg) and 5-fluorouracil (1000 mg) was added once to three times preoperatively to patients with large breast tumors or bulky axillary lymph node metastases (N2) for the purpose of performing breast-conserving surgery or controlling metastatic bulky lymph nodes.…”

Section: Methodsmentioning

confidence: 99%

Sentinel node biopsy in breast cancer patients treated with neoadjuvant chemotherapy

Tanaka

Maeda²,

Ogawa³

et al. 2006

Oncol Rep

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Abstract.A sentinel node biopsy (SNB) has been proved to be an accurate method to estimate the axillary lymph node status as a replacement for axillary lymph node dissection (AxLND) in patients with early breast cancer who have not been treated with neoadjuvant chemotherapy (NAC). We examined the feasibility and accuracy of performing SNB after NAC. Seventy breast cancer patients treated with NAC were enrolled in the current study during the period between March 2001 and June 2005. NAC performed preoperatively consisted of three to four times of CAF chemotherapy. Moreover, intra-arterial (subclavian artery and internal mammary artery) infusion of epirubicin and 5-fluorouracil was performed in addition to systemic CAF chemotherapy once to three times in patients with large breast tumors or bulky axillary lymph node metastases. The sentinel nodes were successfully identified in 63 out of 70 patients (identification rate: 90%). The mean number of sentinel nodes removed per patient was 1.5 (range 1-6). Of the 43 patients in whom AxLND was performed after the sentinel nodes were identified, 19 (44.2%) had positive sentinel nodes. In 8 of those 19 patients, the sentinel node was the only cancer positive lymph node. Among the 24 patients who had negative sentinel nodes it was found that one patient had a confirmed false negative result, thus yielding a false negative rate of 5%, and a sensitivity of 95%. There was no false negative patient who had a clinically negative lymph node status (N0) before NAC (17 patients), whereas the false negative rate was 6.3% in the subgroup of patients with a clinically positive lymph node status (N1, N2) before NAC (26 patients). As a result, SNB after NAC is thus considered to be able to effectively predict the axillary lymph node status in patients with a clinically negative lymph node status before NAC. IntroductionAxillary lymph node dissection (AxLND) has been routinely performed in breast cancer operations, because the regional lymph node status is known to be the most important prognostic factor in breast cancer, as well as being an important decision factor in selecting the optimal postoperative adjuvant therapy. However, there is no evidence that AxLND improves the prognosis of breast cancer patients, and the main therapeutic role of AxLND is thus considered to be to achieve axillary local control. A sentinel node biopsy (SNB) has been rapidly introduced in many institutes to determine the staging for the axilla of breast cancer patients who were supposed to have no axillary lymph node metastasis as a replacement for AxLND which is associated with a higher morbidity than SNB.Patients who showed a complete pathological response (pCR) after neoadjuvant chemotherapy (NAC) proved to have an excellent prognosis (1). As a result the number of institutes that use NAC is increasing. The biggest advantage of NAC is to clarify the cancer characteristics of sensitivity to anti-cancer agents in vivo, which is valuable information for selecting the optimal anti-cancer agents for each breas...

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CT findings of breast cancer with clinically complete response following neoadjuvant chemotherapy - histological correlation

Cited by 5 publications

References 0 publications

Computed Tomography-Guided Localization of Breast Lesions

Computed Tomography-Guided Localization of Breast Lesions

Computed tomography-guided localization of breast lesions

Sentinel node biopsy in breast cancer patients treated with neoadjuvant chemotherapy

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