scholarly journals Correlation between preoperative axillary ultrasound and histopathology of resected lymph nodes in patients with carcinoma breast

Author(s):  
Ab. Hamid Wani ◽  
Anish Gupta ◽  
Nasib Chand Dhigra ◽  
Narinder Sing ◽  
Javid Iqbal

Background: Axillary Ultrasound is an important tool in assessing regional lymph node status in women who are node negative clinically as many of them will prove to have axillary lymph node involvement on histopathology. The aim of the present study was to establish the role of axillary ultrasound in preoperative assessment of lymph node status in women with carcinoma breast and to correlate the findings of axillary ultrasound with the histopathology of resected axillary nodes.Methods: Forty patients (all women) were included in this study and the preoperative axillary ultrasound was done to know the status of axillary lymph nodes and the findings were correlated with histopathological findings of the resected nodes.Results: The sensitivity of axillary ultrasound was found to be 66.67%, specificity was 87.5%, accuracy 75%, positive predictive value (PPV) of 88.89% and negative predictive value of 63.4%.Conclusions: Axillary ultrasound is very important tool in assessing preoperative axillary lymph node status in patients with carcinoma breast. It is also important in assessment after inadequate axillary dissection and for follow up of non-treated axilla.

2021 ◽  
Vol 15 (5) ◽  
pp. 1222-1224
Author(s):  
M. S. Javid ◽  
M. Barry

Objective: To determine the diagnostic accuracy of axillary US as a preoperative investigation by comparing it with the histology outcome of nodal status. Methods: This validation analysis was conducted in Mater Misericordia university hospital, Dublin Ireland form Feb 2007 to Feb 2015. All female patients with impalpable axillary lymph node and histology proven unifocal breast cancer between ages 18 to 75 years were included. Patients with the diagnosis of breast cancer were followed with Ultrasound imaging and results in Picture Archiving and communication system (PACS) and histology was confirmed using the patient center data base in both preoperative and postoperative course of breast cancer, including both sentinel lymph nodes and axillary lymph nodes. Results: A total of 625 patients had axillary ultrasound (US) to assess the preoperative axillary nodal status with mean age of 56±12 years. cN0 was diagnosed in 469 (75%) cases, cN1 in 136 (21.8%) cases and cN2 in 20 (3.2%) cases. After negative axillary ultrasound cN0 pathology shows positive pN2 and pN3 disease in 14 (2.9%) cases with the NPV of 97.01%. Axillary ultrasound had shown cN1 disease in 136 cases with the pathology outcome of pN2 and pN3 in 41 (30.14%) cases with the negative predictive value (NPV) of 69.85%. The overall sensitivity and specificity of the axillary US in detection of the positive node was 51.6% and 92.8% with PPV of 82.69% and NPV of 74.2%. Conclusion: Axillary US is a useful modality for screening of breast cancer patients. The negative US findings exclude the presence of advanced nodal disease. However, it cannot accurate distinguish between pN1 and pN2 or pN3 nodal disease. Keywords: Axillary ultrasound, Axillary lymph nodes, Breast cancer.


2021 ◽  
Vol 28 (7) ◽  
pp. 978-982
Author(s):  
Shahid Hussain Soomro ◽  
◽  
Abdul Sattar Abro ◽  
Vaqar-e-Sahar Shah ◽  
Saima Ather Shaikh ◽  
...  

Objectives: The purpose of current study is to evaluate the correlation of axillary lymph node status with metastases in patients presented with carcinoma breast. Study Design: Prospective study. Setting: Surgical Unit 1, CMC Hospital Larkana. Period: March 2019 to January 2020. Material & Methods: Female patients presented with carcinoma breast were assessed clinically and by investigation then underwent a mastectomy and axillary dissection (sampling or clearance). Data was entered into pre-designed proforma. After proper staging, surgery was done in all patients accordingly. Lymph node involvement was confirmed histopathology. Then it was correlated with clinical findings. Results: Fifty-five female patients of proven carcinoma breast underwent a mastectomy and axillary dissection. The majority of the patients (76%) were between 30-60 years, the median age being 45 years. The left breast contained the tumor in 30 (55.5%) patients while the rest of the patients had the right breast involved. The size of the tumor varied from 2cm to 12cm. 33 (61%) patients were in the pre-menopausal state while 21 (38.88%) were in postmenopausal state. In 07 patients (13%) the axillary lymph nodes were not palpable while in the rest of the 47 patients (87%), the axillary lymph nodes were palpable to a variable extent. Most of the patients were in an advanced stages. Among seven patients (N0), histopathology revealed positive lymph nodes in 3/7 (42.85%) patients. Conclusion: Breast carcinoma is a serious type of carcinoma affecting the younger generation in our community, usually diagnosed at a late stage. Clinical examination is not an effective way for proper staging. Further investigations should be performed for accurate staging and management.


2016 ◽  
Vol 3 (33) ◽  
pp. 1576-1580
Author(s):  
Sanjeeb Kumar Pradhan ◽  
Bhupati Bhusan Das ◽  
Niranjan Sahoo ◽  
Sushanta Kumar Das ◽  
Charan Panda

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 757
Author(s):  
Sanaz Samiei ◽  
Renée W. Y. Granzier ◽  
Abdalla Ibrahim ◽  
Sergey Primakov ◽  
Marc B. I. Lobbes ◽  
...  

Radiomics features may contribute to increased diagnostic performance of MRI in the prediction of axillary lymph node metastasis. The objective of the study was to predict preoperative axillary lymph node metastasis in breast cancer using clinical models and radiomics models based on T2-weighted (T2W) dedicated axillary MRI features with node-by-node analysis. From August 2012 until October 2014, all women who had undergone dedicated axillary 3.0T T2W MRI, followed by axillary surgery, were retrospectively identified, and available clinical data were collected. All axillary lymph nodes were manually delineated on the T2W MR images, and quantitative radiomics features were extracted from the delineated regions. Data were partitioned patient-wise to train 100 models using different splits for the training and validation cohorts to account for multiple lymph nodes per patient and class imbalance. Features were selected in the training cohorts using recursive feature elimination with repeated 5-fold cross-validation, followed by the development of random forest models. The performance of the models was assessed using the area under the curve (AUC). A total of 75 women (median age, 61 years; interquartile range, 51–68 years) with 511 axillary lymph nodes were included. On final pathology, 36 (7%) of the lymph nodes had metastasis. A total of 105 original radiomics features were extracted from the T2W MR images. Each cohort split resulted in a different number of lymph nodes in the training cohorts and a different set of selected features. Performance of the 100 clinical and radiomics models showed a wide range of AUC values between 0.41–0.74 and 0.48–0.89 in the training cohorts, respectively, and between 0.30–0.98 and 0.37–0.99 in the validation cohorts, respectively. With these results, it was not possible to obtain a final prediction model. Clinical characteristics and dedicated axillary MRI-based radiomics with node-by-node analysis did not contribute to the prediction of axillary lymph node metastasis in breast cancer based on data where variations in acquisition and reconstruction parameters were not addressed.


The Breast ◽  
2006 ◽  
Vol 15 (4) ◽  
pp. 533-539 ◽  
Author(s):  
Y.-C. Su ◽  
M.-T. Wu ◽  
C.-J. Huang ◽  
M.-F. Hou ◽  
S.-F. Yang ◽  
...  

2020 ◽  
Author(s):  
Yizhen Zhou ◽  
Lei Zhang ◽  
Zining Jin ◽  
Hailan Yu ◽  
Siyu Ren ◽  
...  

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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