Axillary Ultrasound Accurately Excludes Clinically Significant Lymph Node Disease in Patients With Early Stage Breast Cancer

Annals of Surgery
Natalia S TuckerWilliam E Gillanders

Abstract

Assess the performance characteristics of axillary ultrasound (AUS) for accurate exclusion of clinically significant axillary lymph node (ALN) disease. Sentinel lymph node biopsy (SLNB) is currently the standard of care for staging the axilla in patients with clinical T1-T2, N0 breast cancer. AUS is a noninvasive alternative to SLNB for staging the axilla. Patients were identified using a prospectively maintained database. Sensitivity, specificity, and negative predictive value (NPV) were calculated by comparing AUS findings to pathology results. Multivariate analyses were performed to identify patient and/or tumor characteristics associated with false negative (FN) AUS. A blinded review of FN and matched true negative cases was performed by 2 independent medical oncologists to compare treatment recommendations and actual treatment received. Recurrence-free survival was described using Kaplan-Meier product limit methods. A total of 647 patients with clinical T1-T2, N0 breast cancer underwent AUS between January 2008 and March 2013. AUS had a sensitivity of 70%, NPV of 84%, and PPV of 56% for the detection of ALN disease. For detection of clinically significant disease (>2.0 mm), AUS had a sensitivity of 76% and NPV of 89%. FN A...Continue Reading

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Citations

Mar 27, 2019·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Xi LinGuoxue Tang
Feb 25, 2019·World Journal of Surgical Oncology·Hideo ShigematsuShinji Ozaki
Jul 11, 2018·Annals of Surgical Oncology·Sarah L BlairLorraine Tafra
Dec 19, 2020·European Journal of Radiology·Fabian RiedelJoerg Heil
Mar 20, 2021·Breast Cancer : the Journal of the Japanese Breast Cancer Society·Shinsuke SasadaMorihito Okada
Apr 11, 2021·Breast Cancer Research and Treatment·Stephen KeelanArnold Hill
May 28, 2021·Breast Cancer : Targets and Therapy·Michael Y Chen, William E Gillanders

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