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

Iyengar, Puneeth; Strom, Eric A.; Zhang, Yu Jing; Whitman, Gary J.; Smith, Benjamin D.; Woodward, Wendy A.; Yu, Tse Kuan; Buchholz, Thomas A.

doi:10.1634/theoncologist.2012-0170

Cited by 24 publications

(10 citation statements)

References 16 publications

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“…An earlier, non-overlapping series from our institution demonstrated an N stage upgrade in 37% in women with clinical stage III breast cancer who had regional nodal US performed [19]. Women with metastatic nodal disease confirmed by US-guided needle biopsy routinely receive NAC and comprehensive regional nodal irradiation followed by boost(s) to these areas [20–23].…”

Section: Discussionmentioning

confidence: 99%

Incremental Cancer Detection of Locoregional Restaging with Diagnostic Mammography Combined with Whole-Breast and Regional Nodal Ultrasound in Women with Newly Diagnosed Breast Cancer

et al. 2017

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RATIONALE AND OBJECTIVES To determine if locoregional restaging with diagnostic mammography and ultrasound of the whole breast and regional nodes performed for quality assurance in women with newly-diagnosed breast cancer referred to a tertiary care center yields incremental cancer detection. MATERIALS AND METHODS An institutional review board-approved retrospective, single institution database review was performed on the first 1000 women referred to our center in 2010 with a provisional breast cancer diagnosis. Locoregional restaging consisted of diagnostic full-field digital mammography combined with ultrasound of the whole breast and regional nodal basins. Bilateral whole breast ultrasound was performed in women with contralateral mammographic abnormality or had heterogeneously or extremely dense parenchyma. Demographic, clinical and pathologic factors were analyzed. RESULTS Final analyses included 401 women. 34% (138/401) of women did not have their outside images available for review upon referral. Median age was 54 years, range 21–92; median tumor size was 2.9 cm, range 0.6–18, for women whose disease was upstaged and 2.2 cm, range 0.4–15, for women whose disease was not upstaged. Incremental cancer detection rates were 15.5% (62/401) in the ipsilateral breast and 3.9% (6/154) in the contralateral breast (p<0.0001). Total upstage rate was 25% (100/401). Surgical management changed from segmentectomy to mastectomy in 12% (50/401). Re-excision rate after segmentectomy was 19% (35/189). CONCLUSION Locoregional restaging with diagnostic mammography combined with whole breast and regional nodal ultrasound that is performed for standardization of the imaging workup for newly-diagnosed breast cancer patients can reduce underestimation of disease burden and impact therapeutic planning.

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Section: Discussionmentioning

confidence: 99%

Incremental Cancer Detection of Locoregional Restaging with Diagnostic Mammography Combined with Whole-Breast and Regional Nodal Ultrasound in Women with Newly Diagnosed Breast Cancer

et al. 2017

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“…Ultrasound identified extra-axillary nodal metastases in 37% (n=325) of such patients, thereby leading to changes in these patients’ radiation treatment plans (70). Of those patients with extra-axillary disease, approximately 85% had infraclavicular involvement, 40% had supraclavicular involvement, and 30% had internal mammary involvement.…”

Section: Radiation Therapy Considerations For the Breast Cancer Patientmentioning

confidence: 99%

Paradigm Shifts in Breast Care Delivery: Impact of Imaging in a Multidisciplinary Environment

Krishnamurthy

Bevers

Kuerer

et al. 2017

American Journal of Roentgenology

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The practice of breast imaging in a collaborative multidisciplinary environment adds significant value to outcomes in women’s healthcare. In this article, we describe multidisciplinary considerations in breast cancer screening and early detection, the impact of imaging and histopathologic findings in the diagnostic evaluation and management of breast abnormalities, and the contribution of imaging to surgical and radiation therapy planning for the breast cancer patient.

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“…Twentyeight percent of the patients with extra-axillary regional lymph node involvement had T1 or T2 primary malignancies (90 / 325). 95 In the study by Iyengar et al, in the most common scenario, staging with ultrasound changed the N stage from N1 to N3. In patients who initially presented with T1 or T2 tumors, there was a shift from N1 to N3 disease in 22% of the patients.…”

Section: Stagingmentioning

confidence: 99%

“…In this study, at least 37% of the patients had their radiation therapy plans affected by the use of staging ultrasound. 95 …”

Section: Stagingmentioning

confidence: 99%

Breast Ultrasound: Current Concepts

Candelaria

Hwang

Bouchard

et al. 2013

Seminars in Ultrasound, CT and MRI

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

Cited by 24 publications

References 16 publications

Incremental Cancer Detection of Locoregional Restaging with Diagnostic Mammography Combined with Whole-Breast and Regional Nodal Ultrasound in Women with Newly Diagnosed Breast Cancer

Incremental Cancer Detection of Locoregional Restaging with Diagnostic Mammography Combined with Whole-Breast and Regional Nodal Ultrasound in Women with Newly Diagnosed Breast Cancer

Paradigm Shifts in Breast Care Delivery: Impact of Imaging in a Multidisciplinary Environment

Breast Ultrasound: Current Concepts

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