The Comparative Study of Ultrasonography, Contrast-Enhanced MRI, and 18F-FDG PET/CT for Detecting Axillary Lymph Node Metastasis in T1 Breast Cancer.
10.4048/jbc.2013.16.3.315
- Author:
Seung Ook HWANG
1
;
Sang Woo LEE
;
Hye Jung KIM
;
Wan Wook KIM
;
Ho Yong PARK
;
Jin Hyang JUNG
Author Information
1. Department of Surgery, Kyungpook National University School of Medicine, Daegu, Korea. jjh01@knu.ac.kr
- Publication Type:Comparative Study ; Original Article
- Keywords:
Axilla;
Breast neoplasms;
Diagnostic imaging;
Lymph node excision;
Sentinel lymph node biopsy
- MeSH:
Axilla;
Breast;
Breast Neoplasms;
Diagnostic Imaging;
Electrons;
Fluorodeoxyglucose F18;
Humans;
Lymph Node Excision;
Lymph Nodes;
Magnetic Resonance Imaging;
Neoplasm Metastasis;
Nitriles;
Pyrethrins;
Retrospective Studies;
Sensitivity and Specificity;
Sentinel Lymph Node Biopsy
- From:Journal of Breast Cancer
2013;16(3):315-321
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: A more noninvasive evaluation of axillary lymph node in breast cancer is one of the principal challenges of breast cancer treatment. To detect axillary lymph node metastasis (ALNM) in T1 breast cancer, we have compared the axillary ultrasonography (AUS), contrast-enhanced magnetic resonance imaging (cMRI), and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) to determine the most adequate test or a combination of tests. METHODS: Retrospectively, 349 T1 breast cancer patients who were preoperatively examined using AUS, cMRI, and PET/CT between 2008 and 2011 and whom underwent pathological evaluations of axillary lymph nodes were reviewed and analyzed. RESULTS: In total, 26.4% (92/349) of patients exhibited ALNM. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of AUS for determining ALNM were 44.6%, 88.7%, 58.6%, 81.7%, and 77.1%, respectively. cMRI was similar to AUS. The sensitivity, specificity, PPV, NPV, and accuracy of PET/CT were 44.5%, 94.2%, 73.2%, 82.6%, and 81.1%, respectively. The combination including cMRI and PET/CT was the most accurate with sensitivity, specificity, PPV, NPV, and accuracy values of 39.1%, 98.8%, 92.3%, 81.9%, and 83.1%, respectively. The mean number (3.5+/-4.2) of ALNMs in the patients who were positive based on cMRI and PET/CT and also pathologically proven to exhibit ALNM was significantly larger than the number (2.16+/-2.26) in other patients who exhibited ALNM (p=0.035). CONCLUSION: There are no definitive modalities for detecting ALNM in T1 breast cancers to replace sentinel lymph node biopsy (SLNB). If ALNM is suspected based on cMRI and PET/CT, the axillary dissection without SLNB might be a better option because it is related to high possibilities of ALNM and large axillary metastatic volumes.
