The role of MRI in axillary lymph node imaging in breast cancer patients: a systematic review

Kuijs, V. J. L.; Moossdorff, M.; Schipper, Robert-Jan; Beets‐Tan, Regina G. H.; Heuts, E. M.; Keymeulen, Kristien; Smidt, Marjolein L.; Lobbes, Marc

doi:10.1007/s13244-015-0404-2

Cited by 92 publications

(79 citation statements)

References 31 publications

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“…A number of quantitative MRI techniques that can describe tumor characteristics have shown the ability to predict the response of locally advanced breast cancer to NAT. 67 Furthermore, MRI may be essential in evaluating axillary lymph node involvement in breast cancer treatments, 68 and in identification of residual ductal carcinoma in situ following NAT. 45,69 One limitation of the quantitative MRI techniques currently available is that there are no multi-site, multi-vendor studies presently validating them.…”

Section: Emerging Strategiesmentioning

confidence: 99%

Imaging Considerations and Interprofessional Opportunities in the Care of Breast Cancer Patients in the Neoadjuvant Setting

Sorace¹,

Harvey²,

Syed³

et al. 2017

Seminars in Oncology Nursing

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Objective To discuss standard-of-care and emerging imaging techniques employed for screening and detection, diagnosis and staging, monitoring response to therapy, and guiding cancer treatments. Data Sources Published journal articles indexed in the National Library of Medicine database and relevant websites. Conclusion Imaging plays a fundamental role in the care of cancer patients and specifically, breast cancer patients in the neoadjuvant setting, providing an excellent opportunity for interprofessional collaboration between oncologists, researchers, radiologists and oncology nurses. Quantitative imaging strategies to assess cellular, molecular, and vascular characteristics within the tumor is needed to better evaluate initial diagnosis and treatment response. Implications for nursing practice Nurses caring for patients in all settings must continue to seek education on emerging imaging techniques. Oncology nurses provide education about the test, ensure the patient has appropriate pre testing instructions, and manage patient expectations about timing of results availability.

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Section: Emerging Strategiesmentioning

confidence: 99%

Imaging Considerations and Interprofessional Opportunities in the Care of Breast Cancer Patients in the Neoadjuvant Setting

Sorace¹,

Harvey²,

Syed³

et al. 2017

Seminars in Oncology Nursing

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“…Although diagnostic MRI for axillary imaging is thoroughly studied (Lernevall 2000, Harnan et al 2011, Rahbar et al 2012, Ahmed et al 2014, Li et al 2014, Menezes et al 2014, Kuijs et al 2015, MRI studies for target delineation in regional breast RT are scarce. SNB did not affect patient posture endurance for MRI in supine position.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the location of regional LNs varies greatly between patients (Dijkema et al 2004). Magnetic resonance imaging (MRI) can image individual axillary LNs better (Lernevall 2000, Harnan et al 2011, Rahbar et al 2012, Ahmed et al 2014, Li et al 2014, Menezes et al 2014, Kuijs et al 2015 in direct relation to surrounding anatomical structures, e.g. the brachial plexus, heart, and chest wall.…”

Section: Introductionmentioning

confidence: 99%

Supine MRI for regional breast radiotherapy: imaging axillary lymph nodes before and after sentinel-node biopsy

et al. 2017

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Regional radiotherapy (RT) is increasingly used in breast cancer treatment. Conventionally, computed tomography (CT) is performed for RT planning. Lymph node (LN) target levels are delineated according to anatomical boundaries. Magnetic resonance imaging (MRI) could enable individual LN delineation. The purpose was to evaluate the applicability of MRI for LN detection in supine treatment position, before and after sentinel-node biopsy (SNB). Twenty-three female breast cancer patients (cTis-3N0M0) underwent 1.5 T MRI, before and after SNB, in addition to CT. Endurance for MRI was monitored. Axillary levels were delineated. LNs were identified and delineated Institute of Physics and Engineering in MedicineOriginal content from this work may be used under the terms of the Creative Commons Attribution 3.0 licence. Any further distribution of this work must maintain attribution to the author(s) and the title of the work, journal citation and DOI. on MRI from before and after SNB, and on CT, and compared by Wilcoxon signed-rank tests. LN locations and LN-based volumes were related to axillary delineations and associated volumes. Although postoperative effects were visible, LN numbers on postoperative MRI (median 26 LNs) were highly reproducible compared to preoperative MRI when adding excised sentinel nodes, and higher than on CT (median 11, p < 0.001). LN-based volumes were considerably smaller than respective axillary levels. Supine MRI of LNs is feasible and reproducible before and after SNB. This may lead to more accurate RT target definition compared to CT, with potentially lower toxicity. With the MRI techniques described here, initiation of novel MRI-guided RT strategies aiming at individual LNs could be possible.

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“…In addition, the sensitivity of AUS with two cycles of NAC reached 80.2%, which is as high as that of MRI [21]. However, when six cycles of NAC were adopted, the sensitivity decreased from 80.2% to 56.7%.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of axillary ultrasound after different neoadjuvant chemotherapy cycles in breast cancer patients

Zhao

et al. 2016

Oncotarget

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BackgroundThis study determined whether axillary ultrasound (AUS) accurately predicted the status of axillary lymph nodes of patients who received different number of cycles of neoadjuvant chemotherapy (NAC).Materials and MethodsFrom 2008 to 2015, 656 cases of patients with breast cancers who received NAC and had subsequent axillary lymph node dissection were included in this study. The findings of preoperative AUS were tested by pathological examination. We evaluated the sensitivity, specificity and accuracy of AUS for patients who received two-, four-, and six-cycle NAC.ResultsIn the two-cycle subgroup, the sensitivity (Sn), specificity (Sp) and diagnostic odds ratio (DOR) were 80.2% (95% CI: 74.3%-86.2%), 61.4% (95% CI: 48.8%-74.0%) and 6.64 (95% CI: 3.36-12.4) respectively. In the four-cycle subgroup, the Sn, Sp and DOR were 69.7% (95% CI: 62.2%-77.1%), 66.1% (95% CI: 53.7%-78.5%) and 4.47 (95% CI: 2.32-8.62), respectively. In the six-cycle subgroup, the Sn, Sp and DOR were 56.7% (95% CI: 49.5%-64.0%), 74.5% (95% CI: 62.8%-87.2%) and 3.83 (95% CI: 1.863-7.86), respectively. Furthermore, the patients with normal AUS findings after six cycles of NAC have few positive nodes than patients with suspicious findings (p < 0.001).ConclusionPreoperative AUS is a potentially useful imaging modality to predict the pathologic status of the axillary within four cycles of NAC. Although the accuracy is lower for patients who completed six cycles of NAC than that who received four- and two- cycles, the number of positive lymph nodes for patients with normal findings on AUS is low.

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The role of MRI in axillary lymph node imaging in breast cancer patients: a systematic review

Cited by 92 publications

References 31 publications

Imaging Considerations and Interprofessional Opportunities in the Care of Breast Cancer Patients in the Neoadjuvant Setting

Imaging Considerations and Interprofessional Opportunities in the Care of Breast Cancer Patients in the Neoadjuvant Setting

Supine MRI for regional breast radiotherapy: imaging axillary lymph nodes before and after sentinel-node biopsy

Accuracy of axillary ultrasound after different neoadjuvant chemotherapy cycles in breast cancer patients

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