Pretreatment axillary ultrasonography and core biopsy in patients with suspected breast cancer: diagnostic accuracy and impact on management
Autor: | Marina Benito, Pilar Rioja Torres, Ana Benitez Velasco, Maria Jose Garcia-Ortega, Elena Fuentes Vahamonde, María Martínez Paredes |
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Rok vydání: | 2009 |
Předmět: |
Adult
medicine.medical_specialty Axillary lymph nodes Sentinel lymph node Breast Neoplasms Sensitivity and Specificity Breast cancer Predictive Value of Tests Biopsy medicine Humans Radiology Nuclear Medicine and imaging Lymph node Aged Neoplasm Staging Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Sentinel Lymph Node Biopsy Biopsy Needle Cancer General Medicine Middle Aged medicine.disease medicine.anatomical_structure Lymphatic Metastasis Axilla Female Radiology Breast disease Lymph Nodes Ultrasonography Mammary Breast reconstruction business |
Zdroj: | European journal of radiology. 79(1) |
ISSN: | 1872-7727 |
Popis: | Preoperative diagnosis of axillary metastases in breast cancer patients enables treatment planning. We aimed to evaluate the diagnostic accuracy of axillary ultrasonography and percutaneous biopsy, both alone and in combination, in detecting axillary metastases in patients with breast cancer and to assess the impact of these techniques on the patients’ management. Materials and methods Retrospective study of consecutive patients with suspected breast cancer examined between October 2006 and December 2008. The diagnosis of a primary tumor was histologically confirmed in all patients. All patients underwent axillary ultrasonography and percutaneous core biopsy (14G) of suspicious lymph nodes. We evaluated the morphological characteristics of the lymph nodes by ultrasonography. We calculated the diagnostic accuracy of ultrasonography and of core biopsy, and assessed the impact of these techniques on patients’ treatment. Results We evaluated 675 axillary regions and performed 291 core biopsies of axillary lymph nodes in 662 patients. In 650 patients, breast cancer was histologically confirmed and in 12 patients malignant tumors in other locations were confirmed. The sensitivity and specificity of axillary ultrasonography were 63.2% and 88.7%, respectively. The absence of a fatty hilum within the lymph node was the ultrasonographic finding with the highest positive predictive value for malignancy (93.1%). The sensitivity and specificity of axillary core biopsy were 69.1% and 100%, respectively. Sentinel lymph node biopsy was avoided in 33% of initial candidates and immediate breast reconstruction was undertaken in 35.1% of the patients with mastectomy and negative axillary core biopsy. Conclusions Ultrasonography and axillary core biopsy enable adequate pretreatment staging in patients with breast cancer and has a positive impact on their management. |
Databáze: | OpenAIRE |
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