scholarly journals A comparative study to evaluate the efficacy of the USG and USG guided FNAC of axillary lymph node of carcinoma breast in clinically node negative cases

2017 ◽  
Vol 4 (5) ◽  
pp. 1614
Author(s):  
Ramesh H. ◽  
Praveen K. N. ◽  
Akshay V. Gokak ◽  
Abhijit D. H.
Keyword(s):  
Lymph Node ◽  
Breast Carcinoma ◽  
Comparative Study ◽  
Lymph Nodes ◽  
Axillary Lymph Node ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Reliable Technique ◽  
Node Negative ◽  
Negative Predictor

Background: Breast cancer remains the most common malignancy among women and accounts for 32% of all cancers in women. The average age of developing cancer is shifted from 50-70 years to 30-50 years. Cancers in young tend to be more aggressive. In the absence of distant metastasis, assessment of axillary status is the important part of initial staging process because of its subsequent importance in management. And the absence of presence or absence of axillary metastasis is the strongest prognostic indicator available for breast carcinoma. The objectives were to assess the accuracy USG and USG guided FNAC of axillary lymph nodes of carcinoma breasts in clinically node negative cases and to determine USG guided FNAC can be used to detect axillary lymph nodes metastasis.Methods: This was a comparative study conducted at KIMS Hospital from November 2013 to November 2015. All the patients with clinically node negative carcinoma breasts were evaluated with USG Axilla and those found to be having lymph nodes were subjected to USG guided FNAC and these were correlated with the HPR report.Results: A total 12 patients who satisfied the inclusion criteria were included in study. The most common age group involved in this study was 30-40 years. Upper outer quadrant was the most common location of the group. The sensitivity of the USG in detecting axillary lymph node was 50%, specificity 75%, positive predictor value 805, negative predictor value 42.8% and accuracy of 58.3%. Sensitivity of USG guided FNAC was 50%, specificity 100%, positive predictor value 100%, negative predictor value 50% and accuracy of 66.6%.Conclusions: In conclusion USG-FNAC of axillary lymph node is a simple, minimally invasive and reliable technique for the initial determination of ALN status in patients with breast carcinoma. In present study, the PPV of 100% and NPV of 50% indicate that the predictor power of a positive result is excellent but as expected a negative result is less helpful.

A high number of tumor free axillary lymph nodes from patients with lymph node negative breast carcinoma is associated with poor outcome

Cancer ◽  
2002 ◽  
Vol 94 (8) ◽  
pp. 2307-2309 ◽  
Author(s):  
Rosemary R. Millis ◽  
Robert J. Springall ◽  
Andrew M. Hanby ◽  
Kenneth Ryder ◽  
Ian S. Fentiman
Keyword(s):  
Lymph Node ◽  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Node Negative ◽  
Poor Outcome

scholarly journals Dedicated Axillary MRI-Based Radiomics Analysis for the Prediction of Axillary Lymph Node Metastasis in Breast Cancer

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 757
Author(s):  
Sanaz Samiei ◽  
Renée W. Y. Granzier ◽  
Abdalla Ibrahim ◽  
Sergey Primakov ◽  
Marc B. I. Lobbes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Axillary Lymph Node ◽  
Axillary Lymph Node Metastasis ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Mr Images ◽  
Node Metastasis

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.

scholarly journals Omitting radiotherapy is safe in breast cancer patients ≥ 70 years old after breast-conserving surgery without axillary lymph node operation

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ying Zhong ◽  
Yali Xu ◽  
Yidong Zhou ◽  
Feng Mao ◽  
Yan Lin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Axillary Lymph Node ◽  
Breast Conserving Surgery ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Breast Radiotherapy ◽  
Metastasis Rate

Abstract To verify whether omitting radiotherapy from breast cancer treatment for patients ≥ 70 years old following breast-conserving surgery (BCS) without axillary lymph node dissection is safe. Previous studies have shown that omitting breast radiotherapy after BCS and axillary lymph node dissection is safe for elderly breast cancer patients. We aimed to evaluate the safety of BCS without axillary surgery or breast radiotherapy (BCSNR) in elderly patients with breast cancer and clinically negative axillary lymph nodes. We performed a retrospective analysis of 481 patients with breast cancer, aged ≥ 70 years, between 2010 and 2016. Of these, 302 patients underwent BCSNR and 179 underwent other, larger scope operations. Local recurrence rate, ipsilateral breast tumor recurrence (IBTR) rate, distant metastasis rate, breast-related death, disease-free survival (DFS), and overall survival (OS) were compared between the two groups. After a median follow-up of 60 months, no significant differences in local recurrence, distant metastasis rate, breast-related death, and DFS were noted. The OS was similar (P = 0.56) between the BCSNR group (91.7%) and other operations group (93.0%). The IBTR rate was considered low in both groups, however resulted greater (P = 0.005) in the BCSNR group (5.3%) than in other operations group (1.6%). BCSNR did not affect the survival of elderly patients with breast cancer with clinically negative axillary lymph nodes. IBTR was infrequent in both groups; however, there was a significant difference between the two groups. BCSNR is a feasible treatment modality for patients with breast cancer ≥ 70 years old with clinically negative axillary lymph nodes.

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