Pretreatment axillary ultrasonography and core biopsy in patients with suspected breast cancer: Diagnostic accuracy and impact on management

García-Ortega, M.J.; Benito, Marina Álvarez; Vahamonde, Elena Fuentes; Torres, Pio; Velasco, Ana; Paredes, María Martínez

doi:10.1016/j.ejrad.2009.12.011

Cited by 56 publications

(37 citation statements)

References 22 publications

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“…Benign sonographic features are a predominantly hyperechoic LN due to fat replacement, the presence of a thin homogeneous symmetrical cortical rim around the hyperechoic hilar fat, and symmetric cortical lobulations similar to contralateral ALNs [13.] Suspicious or metastatic nodes may have thickening or eccentric lobulation of the hypoechoic cortical rim, compression or displacement of the fatty hyperechoic hilum, or complete replacement of the hilar fat by hypoechoic tissue [14]. However, sensitivity of gray-scale U/S alone in detection of malignant ALNs is reported to range from 42% to 56% and specificity from 70% to 90% [15].…”

Section: Discussionmentioning

confidence: 99%

Contrast-Enhanced Color Doppler Ultrasonography for Preoperative Evaluation of Sentinel Lymph Node in Breast Cancer Patients

et al. 2015

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Background: Sentinel lymph node (SLN) biopsy is the standard of care for breast cancer patients with non-palpable axillary lymph nodes. We evaluated the usefulness of contrast-enhanced ultrasonography in preoperative detection of malignant SLNs. Methods: 50 patients with breast cancer (median age: 60 years) underwent a color power Doppler ultrasonography with intravenous contrast (Sonovue®) preoperatively, and findings suggestive of metastatic disease to the SLN were documented. The final histopathological report and the radiological preoperative record were compared. Finally, the sensitivity, specificity and diagnostic accuracy of this evolving diagnostic modality were calculated. Results: Contrast-enhanced ultrasound scan identified a negative SLN in the axilla of 27 patients and final histopathology was negative for 30 cases in total, so negative predictive value was calculated as 90% and positive predictive value was 75%. Overall sensitivity was 83.33% and specificity was 84.38%. Moreover, the ability of contrast-enhanced ultrasound to differentiate between SLN status was only statistically significantly correlated with the actual final histopathological report (p < 0.001), while successful ultrasound prediction was not correlated with any factor. Conclusions: SLN status can be evaluated preoperatively using contrast-enhanced color Doppler ultrasonography with high accuracy.

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Section: Discussionmentioning

confidence: 99%

Contrast-Enhanced Color Doppler Ultrasonography for Preoperative Evaluation of Sentinel Lymph Node in Breast Cancer Patients

et al. 2015

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“…When pathology assessment was performed before nast in our cohort, the most common method was fine-needle aspiration or core-needle biopsy. The accuracy of those methods has been investigated, and in clinically suspicious lymph nodes, the sensitivity falls into the 60%-70% range, with the specificity approaching 100% 14,15,27 .…”

Section: Discussionmentioning

confidence: 99%

“…Diagnostic imaging-including ultrasonography, magnetic resonance imaging, or combined positron-emission tomography and computed tomography-does not have sufficient specificity or sensitivity to replace pathology assessment 14,15 . Several recent publications have shown a lower risk of recurrence after pathologic complete response; however, a pathologic complete response after nast does not entirely eliminate the risk of recurrence [16][17][18][19] [a question that is currently under examination (https:// clinicaltrials.gov/ct2/show/NCT01872975)].…”

Section: Introductionmentioning

confidence: 99%

Neoadjuvant Systemic Therapy in Breast Cancer: Use and Trends in Radiotherapy Practice

Koulis

Beecham²,

Speers

et al. 2017

Current Oncology

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“…Ultrasound (US) is a simple and well-accepted method to examine axillary and non-axillary lymph nodes associated with breast cancer. Recent publications have reported that routine axillary US combined with cytology or core biopsy is an effective method to evaluate lymph node metastases prior to surgery [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]. Thus, pretreatment axillary US for early breast cancer patients and needle sampling of morphologically abnormal lymph nodes are now widely recommended [36].…”

Section: Background and Objectivementioning

confidence: 99%

Ultrasound-guided fine needle aspiration cytology in staging clinically node-negative invasive breast cancer

et al. 2011

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The aim of this study was to evaluate the value of ultrasound (US)-guided axillary lymph node fine needle aspiration cytology (FNAC) in staging clinically nodenegative invasive breast cancer. Based on retrospective data, we analyzed sensitivity, specificity, and positive and negative predictive value and efficacy of preoperative axillary US-guided FNAC. A total of 108 consecutive female patients with histological-confirmed invasive breast cancer between January 2006 and December 2010 were included. The management decisions were based on cytological results. Twenty-two patients underwent neoadjuvant chemotherapy and 86 remaining patients benefited of primary surgery. Patients with positive cytology or included in neoadjuvant regimens were scheduled for axillary lymph node dissection (ALND), while patient with negative or nondiagnostic cytology underwent sentinel lymph node biopsy. Axillary US-guided FNAC was compared with definitive pathology of surgically removed lymph nodes. Axillary metastases were found in 55 out of 108 patients (50.9%). In these cases we proceeded with ALND. Excluding the group benefiting from neoadjuvant chemotherapy, we could spare a second surgical intervention for 37 out of 86 patients (43%). The axillary US with FNAC has a sensitivity of 73%, a specificity of 85%, a positive predictive value of 89%, and a negative predictive value of 66%. Without taking into account the neoadjuvant chemotherapy group, in which the statistical analyzes might be biased by the complete histological response, specificity and positive predictive value increased to 100% and negative predictive value to 71%. US combined with FNAC of axillary lymph nodes is a simple, minimally invasive, and reproducible diagnostic approach in improving the preoperative axillary staging of invasive breast cancer patients.Keywords Invasive breast cancer . Axillary node ultrasound . Axillary node cytology . Sentinel lymph node Background and objective

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Pretreatment axillary ultrasonography and core biopsy in patients with suspected breast cancer: Diagnostic accuracy and impact on management

Cited by 56 publications

References 22 publications

Contrast-Enhanced Color Doppler Ultrasonography for Preoperative Evaluation of Sentinel Lymph Node in Breast Cancer Patients

Contrast-Enhanced Color Doppler Ultrasonography for Preoperative Evaluation of Sentinel Lymph Node in Breast Cancer Patients

Neoadjuvant Systemic Therapy in Breast Cancer: Use and Trends in Radiotherapy Practice

Ultrasound-guided fine needle aspiration cytology in staging clinically node-negative invasive breast cancer

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