The roles of 18F-FDG-PET/CT and US-guided FNAC in assessment of axillary nodal metastases in breast cancer patients

Nakano, Yukiko; Noguchi, Masakuni; Yokoi-Noguchi, Miki; Ohno, Yukako; Morioka, Emi; Kosaka, Takeo; Takahashi, Toru; Minato, Hiroshi

doi:10.1007/s12282-016-0684-5

Cited by 15 publications

(20 citation statements)

References 36 publications

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“…First, the percentages of patients with extensive nodal involvement were 23.2% [40], 32.4% [32], and 64.0% [42] in three studies when PET/CT was positive for axillary nodal involvement. These newly diagnosed breast cancer patients all had clinically negative axillae.…”

Section: Resultsmentioning

confidence: 99%

Can We Identify or Exclude Extensive Axillary Nodal Involvement in Breast Cancer Patients Preoperatively?

Leenders¹,

Kramer²,

Belghazi³

et al. 2019

Journal of Oncology

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Background Breast cancer treatment has rapidly changed in the last few years. Particularly, treatment of patients with axillary nodal involvement has evolved after publication of several randomized clinical trials. Omitting axillary lymph node dissection in selected early breast cancer patients with one or two positive sentinel nodes did not compromise overall survival nor regional disease control in these trials. Hence, either excluding or identifying extensive axillary nodal involvement becomes increasingly important. Purpose To evaluate whether the current diagnostic modalities can accurately identify or exclude extensive axillary nodal involvement. Evaluated modalities were axillary ultrasound, ultrasound-guided needle biopsy, MRI, and PET/CT. Methods A literature search was performed in the Cochrane Library, EMBASE, and PubMed databases up to June 2019. The search strategy included terms for breast cancer, lymph nodes, and the different imaging modalities. Only articles that reported pathological N-stage or the total number of positive axillary lymph nodes were considered for inclusion. Studies with patients undergoing neoadjuvant systemic therapy were excluded. Conclusion There is no evidence that any of the current preoperative axillary imaging modalities can accurately exclude or identify breast cancer patients with extensive nodal involvement. Both negative PET/CT and negative MRI scans (with gadolinium-based contrast agents) are promising in excluding extensive nodal involvement. Larger studies should be performed to strengthen this conclusion. False-negative rates of axillary ultrasound and ultrasound-guided needle biopsy are too high to rely on negative results of these modalities in excluding extensive nodal involvement.

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Section: Resultsmentioning

confidence: 99%

Can We Identify or Exclude Extensive Axillary Nodal Involvement in Breast Cancer Patients Preoperatively?

Leenders¹,

Kramer²,

Belghazi³

et al. 2019

Journal of Oncology

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“… 21 Although CT can be informative with regard to axillary disease burden, it is less sensitive than biopsy, such that our findings may ultimately be underestimates of nodal involvement. 22 On the other hand, because PET-CT may also yield false-positives due to reactive lymphadenopathy, 23 we characterized a node as positive only if it had the combination of highly suspicious morphologic and metabolic features as described.…”

Section: Discussionmentioning

confidence: 99%

Regional Lymph Node Involvement Among Patients With De Novo Metastatic Breast Cancer

et al. 2020

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IMPORTANCE Regional nodal irradiation (RNI) for node-positive breast cancer reduces distant metastases and improves survival, albeit with limited reduction in regional nodal recurrences. The mechanism by which RNI robustly reduces distant metastases while modestly influencing nodal recurrences (ie, the presumed target of RNI) remains unclear. OBJECTIVE To determine whether some distant metastases putatively arise from occult regional nodal disease and whether regional recurrences otherwise remain largely undetected until an advanced cancer presentation.

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“…Recently, to evaluate their diagnostic ability in this area, other techniques have been tested, such as positron emission sonography, positron emission sonography/ computed tomography, and magnetic resonance imaging. [26][27][28][29] However, a newer sonographic modality has been available for some time now: contrast-enhanced sonography. Thanks to it, we can obtain reference points for the vascularization pattern of a given organ.…”

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confidence: 99%

Role of Contrast‐Enhanced Sonography in the Evaluation of Axillary Lymph Nodes in Breast Carcinoma: A Monocentric Study

Agliata

Valeri

Argalia

et al. 2017

J of Ultrasound Medicine

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The roles of 18F-FDG-PET/CT and US-guided FNAC in assessment of axillary nodal metastases in breast cancer patients

Abstract: Positive FDG uptake in the axilla does not always indicate axillary metastasis. US-guided FNAC is useful to avoid unnecessary ALND in patients with positive F-FDG uptake. However, SLN biopsy is needed in patients with negative US findings of the ALNs and those with negative FNAC.

Cited by 15 publications

References 36 publications

Can We Identify or Exclude Extensive Axillary Nodal Involvement in Breast Cancer Patients Preoperatively?

Can We Identify or Exclude Extensive Axillary Nodal Involvement in Breast Cancer Patients Preoperatively?

Regional Lymph Node Involvement Among Patients With De Novo Metastatic Breast Cancer

Role of Contrast‐Enhanced Sonography in the Evaluation of Axillary Lymph Nodes in Breast Carcinoma: A Monocentric Study

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