Analysis of Prognoses according to Breast MRI Results in Patients with Axillary Lymph Node Metastases from an Unknown Primary Origin
- Author:
E-Ryung CHOI
1
;
Ok Hee WOO
;
Eun Young KO
;
Boo-Kyung HAN
;
Ji Soo CHOI
;
Eun Sook KO
;
Haejung KIM
;
Myoung Kyoung KIM
;
Jeong Eon LEE
Author Information
- Publication Type:Original Article
- From:Yonsei Medical Journal 2023;64(10):633-640
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:To compare the prognosis of patients with axillary adenocarcinoma from an unknown primary (ACUPax) origin with negative MRI results and those with MRI-detected primary breast cancers.
Materials and Methods:The breast MRI images of 32 patients with ACUPax without signs of primary breast cancer on mammography and ultrasound (US) were analyzed. Spot compression-magnification mammography and second-look US were performed for the area of MRI abnormality in patients with positive results; any positive findings corresponding to the MRI abnormality were confirmed by biopsy. If suspicious MRI lesions could not be localized on mammography or US, MR-guided biopsy or excision biopsy after MR-guided localization was performed. We compared the prognosis of patients with negative breast MRI with that for patients with MRI-detected primary breast cancers.
Results:Primary breast cancers were confirmed in 8 (25%) patients after breast MRI. Primary breast cancers were not detected on MRI in 24 (75%) patients, including five cases of false-positive MRI results. Twenty-three patients underwent axillary lymph node dissection (ALND) followed by whole breast radiation therapy (WBRT) and chemotherapy (n=17) or subsequent chemotherapy only (n=2). Recurrence or distant metastasis did not occur during follow up in 7/8 patients with MRI-detected primary breast cancers and 22/24 patients with negative MRI results. Regional recurrence or distant metastasis did not occur in any MR-negative patient who received adjuvant chemotherapy after ALND and WBRT.
Conclusion:The prognoses of MR-negative patients with ACUPax who received ALND and WBRT followed by chemotherapy were as good as those of patients with MRI-detected primary breast cancers.
