Utility of Preoperative Ultrasound for Predicting pN2 or Higher Stage Axillary Lymph Node Involvement in Patients With Newly Diagnosed Breast Cancer

Abstract

Ultrasound was useful for predicting pN2 or higher axillary disease in breast cancer patients. Preoperative ultrasound assessment for staging of axillary lymph nodes might help avoid underestimation at sentinel lymph node biopsy.

The Z0011 Trial: Is this the end of axillary ultrasound in the pre-operative assessment of breast cancer patients?

“…Supporting our results demonstrating correlation between AxUS nodal burden and nodal burden on final histology, Hiroyuki et al [25] found that a normal AxUS predicted the likelihood of pN0-1 disease, suggesting that SLNB would likely be sufficient for further axillary staging in these patients. Furthermore, when ≥2 abnormal nodes were noted on AxUS, this predicted pN2 disease or worse with a PPV of 82 %.…”

Normal Axillary Ultrasound Excludes Heavy Nodal Disease Burden in Patients with Breast Cancer

“…However, two previous studies focused on ultrasound's ability to discriminate between minimal and heavy axillary metastatic burden and, comparable to the present analysis, both demonstrated that patients with negative AUS had a less than 5 % prevalence of pN2-pN3 disease on final pathology. 11,12 The present study found that lobular carcinoma and CpT2 size were associated with increased likelihood of false negative AUS results. Several previous studies have examined the association of patient and tumor characteristics with false-negative AUS.…”

Usefulness of Breast MRI for Safe Omission of Axillary Lymph Nodes Dissection in Sentinel Node-Positive Breast Cancer Patients

“…Various attempts have been made to predict axillary LNM to avoid ALND safely [9] [10]. Several predicting models have been developed [8] [11]- [18], and many studies have been done to select the best preoperative method for predicting axillary LNM [14] [15] [17] [18]. However, the best method to do so has not been established.…”