scholarly journals Imaging features of sentinel lymph node mapped by multidetector-row computed tomography lymphography in predicting axillary lymph node metastasis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaochan Ou ◽  
Jianbin Zhu ◽  
Yaoming Qu ◽  
Chengmei Wang ◽  
Baiye Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Computed Tomography ◽  
Regression Analysis ◽  
Lymph Node ◽  
Cortical Thickness ◽  
Multidetector Row Computed Tomography ◽  
Axillary Lymph ◽  
Imaging Features ◽  
Short Axis ◽  
Breast Cancer Patients

Abstract Introduction Accurately assessing axillary lymph node (ALN) status in breast cancer is vital for clinical decision making and prognosis. The purpose of this study was to evaluate the predictive value of sentinel lymph node (SLN) mapped by multidetector-row computed tomography lymphography (MDCT-LG) for ALN metastasis in breast cancer patients. Methods 112 patients with breast cancer who underwent preoperative MDCT-LG examination were included in the study. Long-axis diameter, short-axis diameter, ratio of long-/short-axis and cortical thickness were measured. Logistic regression analysis was performed to evaluate independent predictors associated with ALN metastasis. The prediction of ALN metastasis was determined with related variables of SLN using receiver operating characteristic (ROC) curve analysis. Results Among the 112 cases, 35 (30.8%) cases had ALN metastasis. The cortical thickness in metastatic ALN group was significantly thicker than that in non-metastatic ALN group (4.0 ± 1.2 mm vs. 2.4 ± 0.7 mm, P < 0.001). Multi-logistic regression analysis indicated that cortical thickness of > 3.3 mm (OR 24.53, 95% CI 6.58–91.48, P < 0.001) had higher risk for ALN metastasis. The best sensitivity, specificity, negative predictive value(NPV) and AUC of MDCT-LG for ALN metastasis prediction based on the single variable of cortical thickness were 76.2%, 88.5%, 90.2% and 0.872 (95% CI 0.773–0.939, P < 0.001), respectively. Conclusion ALN status can be predicted using the imaging features of SLN which was mapped on MDCT-LG in breast cancer patients. Besides, it may be helpful to select true negative lymph nodes in patients with early breast cancer, and SLN biopsy can be avoided in clinically and radiographically negative axilla.

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

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.

scholarly journals Imaging Predictors for Nonsentinel Lymph Node Metastases in Breast Cancer Patients

Breast Care ◽  
2019 ◽  
Vol 15 (4) ◽  
pp. 372-379
Author(s):  
Yizi Cong ◽  
Suxia Wang ◽  
Haidong Zou ◽  
Shiguang Zhu ◽  
Xingmiao Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Tumor Size ◽  
Tumor Burden ◽  
Axillary Lymph ◽  
Imaging Features ◽  
Breast Cancer Patients ◽  
Size Number ◽  
Positive Slns ◽  
Nonsentinel Lymph Node

Background: The relationship between imaging features and nonsentinel lymph node (NSLN) metastasis is not clear. Objectives: To determine whether imaging features could predict NSLN metastasis in sentinel lymph node (SLN)-positive breast cancer patients and to provide new clues for avoiding unnecessary axillary lymph node dissection. Method: 171 patients with clinically negative axillary lymph nodes and a pathologically positive SLN were recruited between January 2007 and January 2014. According to the Breast Imaging Reporting and Data System (BI-RADS), the effects of clinicopathological factors, especially imaging features, on NSLN metastases were assessed by univariate and multivariate statistical analyses. Results: The average number of dissected SLNs was 2.11 (range, 1–6); 56 of the 171 (32.75%) patients exhibited NSLN metastases. In univariate analysis, tumor size, number of positive SLNs, ratio of positive SLNs, mammographic mass margins, ultrasonographic mass margins, and ultrasonographic vascularity were significantly correlated with NSLN involvement. Furthermore, through multivariate analysis, tumor size, number of positive SLNs, mammographic mass margins, and ultrasonographic vascularity were still independent predictors of NSLN involvement. Additionally, in SLN-positive patients, number of positive SLNs and ultrasonographic vascularity could also predict the tumor burden in NSLN. Conclusions: In addition to tumor size and the number of positive SLNs, mammographic mass margins and ultrasonographic vascularity were also independent predictors of NSLN metastases in SLN-positive patients of breast cancer. The number of positive SLNs and ultrasonographic vascularity could also predict the tumor burden in NSLN.

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

2019 ◽  
Author(s):  
Yizhen Zhou ◽  
Lei Zhang ◽  
Zining Jin ◽  
Hailan Yu ◽  
Siyu Ren ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Predictive Value ◽  
Axillary Lymph Node ◽  
Lymph Node Status ◽  
Axillary Lymph ◽  
Short Axis ◽  
Breast Cancer Patients

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.

scholarly journals Characterization of Axillary Lymph Nodes as Normal, Reactive and Benign Using Conventional Ultrasonography

2016 ◽  
Vol 13 (2) ◽  
pp. 36-45 ◽  
Author(s):  
Farzana Alam ◽  
Md. Menhazul Islam ◽  
Mahbuba Shirin ◽  
Sayeeda Shawkat ◽  
Salahuddin Al Azad ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cortical Thickness ◽  
Area Under Curve ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Short Axis ◽  
Axis Ratio ◽  
Metastatic Lymph

Background:Detection ofabnormalities ofaxillary lymph nodes is important for the diagnosis of different pathologies. Objective:The purpose of this present study was to see the accuracy of conventional USG for the differential diagnosis of axillary lymph nodes. Methodology: This cross sectional study was carried out in the Department of Radiology & Imaging at Bangabandhu Sheikh Mujib Medical University, Dhakafrom July 2012 to June 2013 for a period of one year. In this study normal healthy woman who came for screening of breast disease without any symptoms and did not have any abnormality on USG was included and werecategorized as normal patient. Axillary lymph nodes from the normal patients werecategorized as benign lymph nodes. Patients, who came with the complaints of mastalgia with normal breast findings, were included as patients with mastalgia. The lymph nodes from the patients of mastalgia were considered as reactive lymph nodes and patients with known breast cancer and lymph node metastasis were included as malignant patients. Metastatic lymph nodes from breast cancer patients was included diagnosed by cytopathology or histopathology as metastatic lymph nodes. Following patients’ second visit or final diagnosis the patients were included in the data set. Long axis diameter was taken as longest diameter in long axis. Result: In benign vs reactive lymph node the area under curve for long axis diameter was 0.534 (asymptotic significance 0.307), short axis diameter was 0.589 (asymptotic significance 0.007), sinus length 0.492 (asymptotic significance 0.798), cortical thickness was 0.684 (asymptotic significance 0.0001) short long ratio was 0.570 (asymptotic significance 0.033). In reactive vs metastatic the area under curve for long axis diameter was 0.464 (asymptotic significance 0.391), short axis diameter was 0.741 (asymptotic significance 0.000), sinus length 0.257 (asymptotic significance 0.037), cortical thickness was 0.625 (asymptotic significance 0.003) short long ratio was 0.791 (asymptotic significance 0.000), sinus long ratio 0.279 (asymptotic significance 0.040) cortex short axis ratio .516 (asymptotic significance 0.708).The cut off for short-long axis diameter ratio was 0.43, for short axis was 0.66cm and for cortical thickness 0.37cm. In benign vs metastasis lymph node the area under curve for long axis diameter was 0.533 (asymptotic significance 0.417), short axis diameter was 0.797 (asymptotic significance 0.000), sinus length 0.254 (asymptotic significance 0.000), cortical thickness was 0.757 (asymptotic significance 0.0001) short long ratio was 0.847 (asymptotic significance 0.0001), sinus long ratio 0.241 (asymptotic significance 0.0001) cortex short axis ratio .661 (asymptotic significance 0.0001). Conclusion: To differentiate benign, reactive and metastatic lymph node, cortical thickness and shape are the important parameters. Journal of Science Foundation 2015;13(2):36-45DOI: http://dx.doi.org/10.3329/jsf.v13i2.27933

IV-DSA is a new diagnostic tool for axillary lymph node metastasis in breast cancer patients

2004 ◽  
Vol 87 (2) ◽  
pp. 75-79 ◽  
Author(s):  
Osamu Watanabe ◽  
Tadao Shimizu ◽  
Hiroshi Imamura ◽  
Jun Kinoshita ◽  
Yoshihito Utada ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cancer Patients ◽  
Diagnostic Tool ◽  
Axillary Lymph Node ◽  
Axillary Lymph Node Metastasis ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Node Metastasis

Are Breast Cancer Nomograms Still Valid to Predict the Need for Axillary Dissection?

Oncology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Vilma Madekivi ◽  
Antti Karlsson ◽  
Pia Boström ◽  
Eeva Salminen
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Axillary Dissection ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Axillary Lymph Node Metastases ◽  
Node Negative ◽  
Node Metastases ◽  
External Population

Background: Nomograms can help in estimating the nodal status among clinically node-negative patients. Yet their validity in external cohorts over time is unknown. If the nodal stage can be estimated preoperatively, the need for axillary dissection can be decided. Objectives: The aim of this study was to validate three existing nomograms predicting 4 or more axillary lymph node metastases. Method: The risk for ≥4 lymph node metastases was calculated for n = 529 eligible breast cancer patients using the nomograms of Chagpar et al. [Ann Surg Oncol. 2007;14:670–7], Katz et al. [J Clin Oncol. 2008;26(13):2093–8], and Meretoja et al. [Breast Cancer Res Treat. 2013;138(3):817–27]. Discrimination and calibration were calculated for each nomogram to determine their validity. Results: In this cohort, the AUC values for the Chagpar, Katz, and Meretoja models were 0.79 (95% CI 0.74–0.83), 0.87 (95% CI 0.83–0.91), and 0.82 (95% CI 0.76–0.86), respectively, showing good discrimination between patients with and without high nodal burdens. Conclusion: This study presents support for the use of older breast cancer nomograms and confirms their current validity in an external population.

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