Detection of infraclavicular lymph node metastases using ultrasonography in breast cancer

Abstract

Patients who were identified to have infraclavicular lymph node metastases by preoperative ultrasonographic examination should have a relevant treatment plan as they are classified as locally advanced, stage III-C disease.

Accuracy of Individual Descriptors and Grading of Nodal Involvement by Axillary Ultrasound in Patients of Breast Cancer

“…Altinyollar et al used criteria of loss of fatty hilum from central position, rounding of lymph node, decrease in echogenicity, and presence of eccentric cortical hypertrophy. They reported figures of specificity of 98.3%, sensitivity of 47.5%, positive predictive value of 95%, and negative predictive value of 73.7% [18]. Analysis of these reports shows that most commonly used descriptors of loss of fatty hilum, decrease in echogenecity and round lymph node have shown high sensitivity and specificity rates.…”

“…Although the nodes' hilar fat may remain for some time, it gradually decreases over time. Most of the studies using these descriptors too have reported high rates of diagnostic accuracy [16, 18]. …”

Correlation of clinical examination and ultrasonogram with histopathology in predicting the metastatic axillary lymph nodes in breast cancer

“…They reported a sensitivity of 47.5% and specificity of 98.3%. 9 Bonnema et al in their study of 148 patients showed that sensitivity and specificity of axillary USG for detection of abnormal nodes can be as high as 87% and 56%, if lymph node length was used as the criterion. In contrast, sensitivity and specificity were 36% and 95% respectively when echo pattern of lymph node was used.…”

The Value of Ultrasound in Detecting Extra-Axillary Regional Node Involvement in Patients With Advanced Breast Cancer

“…A possible explanation for the lack of regional ultrasound use may be the lack of high-quality data showing its utility. To date, there have been several small studies that have suggested the potential of regional ultrasound to detect disease in the infraclavicular, supraclavicular, and internal mammary chain regions [2][3][4][5][6][7][8][9][10][11][12][13][14][15]. However, none of those studies quantitatively evaluated the importance of ultrasound in terms of accurate staging and subsequent locoregional treatment management.…”

“…To date, there are only relatively small studies available evaluating the value of regional ultrasound to accurately quantitate regional lymph node disease. In general, these limited data have suggested that ultrasound is more accurate in detecting disease in the axilla, supraclavicular, infraclavicular, and internal mammary regions than mammography and clinical examination [2][3][4][5][6][7][8][9][10][11][12][13][14][15]. At the University of Texas MD Anderson Cancer Center (UTMDACC), the use of ultrasound to assess potential disease in the regional nodal basins (axillary, infraclavicular, supraclavicular, and internal mammary regions) is part of our practice pattern for newly diagnosed breast cancer patients.…”