To Look or Not to Look? Axillary Imaging: Less May Be More

Abstract Axillary lymph node status in patients with breast cancer is an important prognostic indicator and often guides vital treatment decisions. Although in many cases imaging plays a crucial role in the assessment of the axilla, it is essential that targeted axillary US and/or image-guided biopsy of an axillary lymph node be performed by the radiologist only when clinically appropriate. This decision-making process requires multidisciplinary communication and collaboration among radiologists, surgeons, medical oncologists, and radiation oncologists. Our goal is to review axillary imaging for patients with breast cancer in two distinct clinical settings, the patient with newly diagnosed breast cancer who meets American College of Surgeons Oncology Group Z0011 criteria and patients undergoing neoadjuvant chemotherapy, with a specific focus on potential reasons to not perform axillary US and/or image-guided biopsy in these settings.

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Sentinel Lymph Node Evaluation: What the Radiologist Needs to Know

Diagnostics ◽

10.3390/diagnostics9010012 ◽

2019 ◽

Vol 9 (1) ◽

pp. 12 ◽

Cited By ~ 2

Author(s):

Gary Whitman ◽

Raya AlHalawani ◽

Niloofar Karbasian ◽

Rajesh Krishnamurthy

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Sentinel Lymph Node Biopsy ◽

Axillary Lymph Node ◽

Prognostic Indicator ◽

Lymph Node Biopsy ◽

Lymph Node Status ◽

Axillary Lymph ◽

Node Biopsy

Axillary lymph node status is the single most important prognostic indicator in patients with breast cancer. Axillary lymph node dissection, the traditional method of staging breast cancer, is associated with significant morbidity. Sentinel lymph node biopsy has become standard in patients being treated for breast cancer with clinically negative lymph nodes. There is considerable variation in the medical literature regarding technical approaches to sentinel lymph node biopsy in patients with breast cancer. The purpose of this article is to describe our preferred approaches to sentinel lymph node biopsy with a review of the literature.

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Expression of CXCR4 is associated with axillary lymph node status in patients with early breast cancer

The Breast ◽

10.1016/j.breast.2005.08.034 ◽

2006 ◽

Vol 15 (4) ◽

pp. 533-539 ◽

Cited By ~ 27

Author(s):

Y.-C. Su ◽

M.-T. Wu ◽

C.-J. Huang ◽

M.-F. Hou ◽

S.-F. Yang ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Early Breast Cancer ◽

Axillary Lymph Node ◽

Lymph Node Status ◽

Axillary Lymph ◽

Axillary Lymph Node Status ◽

Node Status

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Axillary lymph node metastasis in breast cancer: Prognostic indicator or lead-time bias?

European Journal of Cancer ◽

10.1016/0959-8049(93)90371-l ◽

1993 ◽

Vol 29 (3) ◽

pp. 300-302 ◽

Cited By ~ 17

Author(s):

Indraneel Mittra

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Axillary Lymph Node ◽

Lead Time ◽

Prognostic Indicator ◽

Axillary Lymph Node Metastasis ◽

Axillary Lymph ◽

Node Metastasis ◽

Lead Time Bias

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Role of Ultrasound in the Diagnosis of Lymph Node Status in Axillary Lymph Node Metastases in Breast Cancer undergoing Neoadjuvant Chemotherapy

10.21203/rs.2.17922/v2 ◽

2020 ◽

Author(s):

Yizhen Zhou ◽

Lei Zhang ◽

Zining Jin ◽

Hailan Yu ◽

Siyu Ren ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Neoadjuvant Chemotherapy ◽

Cancer Patients ◽

Axillary Lymph Node ◽

Lymph Node Status ◽

Axillary Lymph ◽

Short Axis ◽

Breast Cancer Patients ◽

Axillary Ultrasound

Abstract Background:Axillary ultrasound (AUS) is one of the important bases for evaluating the axillary status of breast cancer patients. And it would be helpful for the reassessment of axillary lymph node status in these patients after neoadjuvant chemotherapy(NAC) and guide the selection of their axillary surgical options.The purpose of this study was to evaluate the diagnostic performance of ultrasound,and to find out the factors related to the outcome of ultrasound.Methods:In this retrospective analysis, 172 patients (one bilateral breast cancer) with breast cancer and clinical positive axillary nodes, were enrolled. After NAC, all patients received mastectomy and axillary lymph node dissection (ALND). AUS was used before and after NAC to assess the axilla status. Results:Of the 173 axillae, 137 (79.19%) had pathological metastasis after NAC. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of axillary ultrasound in this cohort were 68.21%, 69.34%, 63.89%, 87.96% and 35.38% respectively. Univariate analysis showed that primary axillary lymph node(ALN) short axis, progesterone receptors, hormone receptors, the tumor status after NAC, tumor reduction rate, ALN short axis after NAC, physical examination of axilla after NAC and pN impacted the results of AUS(P = 0.000 ~ 0.040). Multivariate analysis of the above indicators showed that ALN short axis after NAC and pN associated with AUS results independently. Conclusion:AUS can accurately assess axilla status after NAC in most breast cancer patients. If the short axis of ALN≥10mm and AUS negative, SLNB could be chosen. However, AUS cannot detect residual lymph node disease after NAC in a short axis of the ALN <10mm.

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