Metastatic breast carcinoma in axillary lymph nodes: in vitro US detection.

Feu, J.; Tresserra, F.; Fábregas, R.; Navarro, Beatriz de Olaiz; Grases, Pedro; Suris, J C; Fernández-Cid, A; Alegret, X

doi:10.1148/radiology.205.3.9393544

Cited by 96 publications

(89 citation statements)

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“…Sonography can easily explore the different nodal chains and, when LN are found, specific signs may be searched to evaluate the presence of metastases (Feu et al, 1997;Rizzatto, 2001). We here reported a 16% false negative rate by US alone, since 28 out of 172 of US-nonsuspect LN were positive at histology.…”

Section: Discussionmentioning

confidence: 60%

Ultrasonographically-guided fine-needle aspiration of axillary lymph nodes: role in breast cancer management

et al. 2003

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The knowledge of the status of axillary lymph nodes (LN) of patients with breast cancer is a fundamental prerequisite in the therapeutic decision. In the present work, we evaluated the impact of fine-needle aspiration cytology (FNAC) of ultrasonographically (US) selected axillary LN in the diagnosis of LN metastases and subsequently in the treatment of patients with breast cancer. Axillary US was performed in 298 patients with diagnosed breast cancer (267 invasive carcinomas and 31 ductal carcinoma in situ DCIS), and in 95 patients it was followed by FNAC of US suspicious LN. Smears were examined by routine cytological staining. Cases of uncertain diagnosis were stained in immunocytochemistry (ICC) with a combination of anticytokeratin and anti-HMFG2 antibodies. Eighty-five FNAC were informative (49 LN were positive for metastases, 36 were negative). In 49 of 267 patients with invasive breast carcinoma (18%), a preoperative diagnosis of metastatic LN in the axilla could be confirmed. These patients could proceed directly to axillary dissection. In addition, US-guided FNAC presurgically scored 49 out of 88 (55%) metastatic LN. Of all others, with nonsuspicious LN on US (203 cases including 31 DCIS), in which no FNAC examination was performed, 28 invasive carcinomas (16%) turned out to be LN positive on histological examination. Based on these data, US examination should be performed in all patients with breast cancer adding ICC-supported FNAC only on US-suspect LN. This presurgical protocol is reliable for screening patients with LN metastases that should proceed directly to axillary dissection or adjuvant chemotherapy, thus avoiding sentinel lymph node biopsy.

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Section: Discussionmentioning

confidence: 60%

Ultrasonographically-guided fine-needle aspiration of axillary lymph nodes: role in breast cancer management

et al. 2003

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“…A preoperative knowledge of node positivity is seen by some as an indication for neo-adjuvant chemotherapy. The imaging techniques that have been extensively investigated to assess the axilla preoperatively are US with a reported sensitivity of 56 -72% and a specificity of 70 -90% (Bruneton et al, 1986;de Freitas et al, 1991;Vaidya et al, 1996;Feu et al, 1997), scintimammography with a sensitivity of 67 -100% and a specificity of 80 -90% (Dupont et al, 2001;Lumachi et al, 2001), CT with a sensitivity of 90% and a specificity of 82% (March et al, 1991;Uematsu et al, 2001) and colour Doppler with a sensitivity of 76% (Yang et al, 2000(Yang et al, , 2001. The sensitivity and specificity achieved using these techniques does not allow a reliable selection of patients for full axillary clearance or a more minimally invasive procedure.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of axillary nodal metastases by ultrasound-guided core biopsy in primary operable breast cancer

et al. 2003

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The purpose of this study was to examine the use of ultrasound (US)-guided core biopsy of axillary nodes in patients with operable breast cancer. The ipsilateral axillae of 187 patients with suspected primary operable breast cancer were scanned. Nodes were classified based on their shape and cortical morphology. Abnormal nodes underwent US-guided core biopsy/fine needle aspiration (FNA), and the results correlated with subsequent axillary surgery. The nodes were identified on US in 103 of 166 axillae of patients with confirmed invasive carcinoma. In total, 54 (52%) met the criteria for biopsy: 48 core biopsies (26 malignant, 20 benign node, two normal) and six FNA were performed. On subsequent definitive histological examination, 64 of 166 (39%) had axillary metastases. Of the 64 patients with involved nodes at surgery, preoperative US identified nodes in 46 patients (72%), of which 35 (55%) met the criteria for biopsy and 27 (42%) of these were diagnosed preoperatively by US-guided biopsy. In conclusion, US can identify abnormal nodes in patients presenting with primary operable breast cancer. In all, 65% of these nodes are malignant and this can often be confirmed with US-guided core biopsy.

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“…An abnormal lymph node has a thickened or eccentrically bulging cortex and a diminished or absent hilum (Figs 3-5) (22,23). The thickened cortex should be the target at biopsy.…”

Section: Abnormal Lymph Nodementioning

confidence: 99%

US-guided Core Needle Biopsy of Axillary Lymph Nodes in Patients with Breast Cancer: Why and How to Do It

et al. 2007

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Metastatic breast carcinoma in axillary lymph nodes: in vitro US detection.

Abstract: Findings of in vitro US studies of axillary adenopathy provide the basis for the evaluation of lymph node metastasis in vivo before surgery, especially in those lymph nodes 10 mm or larger.

Cited by 96 publications

References 0 publications

Ultrasonographically-guided fine-needle aspiration of axillary lymph nodes: role in breast cancer management

Ultrasonographically-guided fine-needle aspiration of axillary lymph nodes: role in breast cancer management

Diagnosis of axillary nodal metastases by ultrasound-guided core biopsy in primary operable breast cancer

US-guided Core Needle Biopsy of Axillary Lymph Nodes in Patients with Breast Cancer: Why and How to Do It

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