Diagnostic performance of axillary ultrasound and standard breast MRI for differentiation between limited and advanced axillary nodal disease in clinically node-positive breast cancer patients
Preoperative differentiation between limited (pN1; 1–3 axillary metastases) and advanced (pN2–3; ≥4 axillary metastases) nodal disease can provide relevant information regarding surgical planning and guiding adjuvant radiation therapy. The aim was to evaluate the diagnostic performance of preoperati...
Gespeichert in:
| Veröffentlicht in: | Scientific reports 2019-11, Vol.9 (1), p.17476-8, Article 17476 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 8 |
|---|---|
| container_issue | 1 |
| container_start_page | 17476 |
| container_title | Scientific reports |
| container_volume | 9 |
| creator | Samiei, S. van Nijnatten, T. J. A. van Beek, H. C. Polak, M. P. J. Maaskant-Braat, A. J. G. Heuts, E. M. van Kuijk, S. M. J. Schipper, R. J. Lobbes, M. B. I. Smidt, M. L. |
| description | Preoperative differentiation between limited (pN1; 1–3 axillary metastases) and advanced (pN2–3; ≥4 axillary metastases) nodal disease can provide relevant information regarding surgical planning and guiding adjuvant radiation therapy. The aim was to evaluate the diagnostic performance of preoperative axillary ultrasound (US) and breast MRI for differentiation between pN1 and pN2–3 in clinically node-positive breast cancer. A total of 49 patients were included with axillary metastasis confirmed by US-guided tissue sampling. All had undergone breast MRI between 2008–2014 and subsequent axillary lymph node dissection. Unenhanced T2-weighted MRI exams were reviewed by two radiologists independently. Each lymph node on the MRI exams was scored using a confidence scale (0–4) and compared with histopathology. Diagnostic performance parameters were calculated for differentiation between pN1 and pN2–3. Interobserver agreement was determined using Cohen’s kappa coefficient. At final histopathology, 67.3% (33/49) and 32.7% (16/49) of patients were pN1 and pN2–3, respectively. Breast MRI was comparable to US in terms of accuracy (MRI reader 1 vs US, 71.4% vs 69.4%, p = 0.99; MRI reader 2 vs US, 73.5% vs 69.4%, p = 0.77). In the case of 1–3 suspicious lymph nodes, pN2–3 was observed in 30.4% on US (positive predictive value (PPV) 69.6%) and in 22.2–24.3% on MRI (PPV 75.7–77.8%). In the case of ≥4 suspicious lymph nodes, pN1 was observed in 33.3% on US (negative predictive value (NPV) 66.7%) and in 38.5–41.7% on MRI (NPV 58.3–61.5%). Interobserver agreement was considered good (k = 0.73). In clinically node-positive patients, the diagnostic performance of axillary US and breast MRI is comparable and limited for accurate differentiation between pN1 and pN2–3. Therefore, there seems no added clinical value of preoperative breast MRI regarding nodal staging in patients with positive axillary US. |
| doi_str_mv | 10.1038/s41598-019-54017-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6877558</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2317930955</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-2299b02ac0e22b4ff034f2e123a757046c272941cebb1443707f0fd25a58dda83</originalsourceid><addsrcrecordid>eNp9UktrFTEUHkSxpfYPuJCAGzejed7MbARprRYqgug6ZDIn15RMck0yV_13_WlmOn3pwkAecL5HzuFrmucEvyaYdW8yJ6LvWkz6VnBMZIsfNYcUc9FSRunjB--D5jjnS1yXoD0n_dPmgBG5kT3tD5urU6e3IebiDNpBsjFNOhhA0SL9y3mv0280-5J0jnMYka47l3rqNKIhgc4FffpyjioPjc5aSBCK08XFgAYoPwEC8m5yBVauHveL_HgvHuKofeXmqgXIBWS8C85o769r0O5idsXt4dbOLAIJ7apJ9crPmidW-wzHN_dR8-3s_deTj-3F5w_nJ-8uWsMlLy2lfT9gqg0GSgduLWbcUiCUaSkk5htD5TIdA8NAOGcSS4vtSIUW3Tjqjh01b1fd3TxMMJrqnbRXu-Sm2oaK2qm_K8F9V9u4V5tOSiEWgVc3Ain-mCEXNblsoE4hQJyzoox0kuF-wyr05T_QyzinUNtbULKvKCEqiq4ok2LOCezdZwhWS0bUmhFVM6KuM6JwJb142MYd5TYRFcBWQK6lsIV07_0f2T_2fMze</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2317930955</pqid></control><display><type>article</type><title>Diagnostic performance of axillary ultrasound and standard breast MRI for differentiation between limited and advanced axillary nodal disease in clinically node-positive breast cancer patients</title><source>Nature Open Access</source><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><source>Springer Nature OA/Free Journals</source><source>Free Full-Text Journals in Chemistry</source><creator>Samiei, S. ; van Nijnatten, T. J. A. ; van Beek, H. C. ; Polak, M. P. J. ; Maaskant-Braat, A. J. G. ; Heuts, E. M. ; van Kuijk, S. M. J. ; Schipper, R. J. ; Lobbes, M. B. I. ; Smidt, M. L.</creator><creatorcontrib>Samiei, S. ; van Nijnatten, T. J. A. ; van Beek, H. C. ; Polak, M. P. J. ; Maaskant-Braat, A. J. G. ; Heuts, E. M. ; van Kuijk, S. M. J. ; Schipper, R. J. ; Lobbes, M. B. I. ; Smidt, M. L.</creatorcontrib><description>Preoperative differentiation between limited (pN1; 1–3 axillary metastases) and advanced (pN2–3; ≥4 axillary metastases) nodal disease can provide relevant information regarding surgical planning and guiding adjuvant radiation therapy. The aim was to evaluate the diagnostic performance of preoperative axillary ultrasound (US) and breast MRI for differentiation between pN1 and pN2–3 in clinically node-positive breast cancer. A total of 49 patients were included with axillary metastasis confirmed by US-guided tissue sampling. All had undergone breast MRI between 2008–2014 and subsequent axillary lymph node dissection. Unenhanced T2-weighted MRI exams were reviewed by two radiologists independently. Each lymph node on the MRI exams was scored using a confidence scale (0–4) and compared with histopathology. Diagnostic performance parameters were calculated for differentiation between pN1 and pN2–3. Interobserver agreement was determined using Cohen’s kappa coefficient. At final histopathology, 67.3% (33/49) and 32.7% (16/49) of patients were pN1 and pN2–3, respectively. Breast MRI was comparable to US in terms of accuracy (MRI reader 1 vs US, 71.4% vs 69.4%, p = 0.99; MRI reader 2 vs US, 73.5% vs 69.4%, p = 0.77). In the case of 1–3 suspicious lymph nodes, pN2–3 was observed in 30.4% on US (positive predictive value (PPV) 69.6%) and in 22.2–24.3% on MRI (PPV 75.7–77.8%). In the case of ≥4 suspicious lymph nodes, pN1 was observed in 33.3% on US (negative predictive value (NPV) 66.7%) and in 38.5–41.7% on MRI (NPV 58.3–61.5%). Interobserver agreement was considered good (k = 0.73). In clinically node-positive patients, the diagnostic performance of axillary US and breast MRI is comparable and limited for accurate differentiation between pN1 and pN2–3. Therefore, there seems no added clinical value of preoperative breast MRI regarding nodal staging in patients with positive axillary US.</description><identifier>ISSN: 2045-2322</identifier><identifier>EISSN: 2045-2322</identifier><identifier>DOI: 10.1038/s41598-019-54017-0</identifier><identifier>PMID: 31767929</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/308/409 ; 692/4028/546 ; Adult ; Aged ; Axilla - diagnostic imaging ; Axilla - pathology ; Axilla - surgery ; Biopsy ; Breast cancer ; Breast Neoplasms - diagnostic imaging ; Breast Neoplasms - pathology ; Diagnosis, Differential ; Female ; Histopathology ; Humanities and Social Sciences ; Humans ; Lymph Node Excision ; Lymph nodes ; Lymphatic Metastasis - diagnostic imaging ; Lymphatic Metastasis - pathology ; Lymphatic system ; Magnetic Resonance Imaging ; Metastases ; Metastasis ; Middle Aged ; multidisciplinary ; Observer Variation ; Radiation therapy ; Radiographic Image Interpretation, Computer-Assisted ; Science ; Science (multidisciplinary) ; Sensitivity and Specificity ; Ultrasonic imaging ; Ultrasonography ; Ultrasound</subject><ispartof>Scientific reports, 2019-11, Vol.9 (1), p.17476-8, Article 17476</ispartof><rights>The Author(s) 2019</rights><rights>2019. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-2299b02ac0e22b4ff034f2e123a757046c272941cebb1443707f0fd25a58dda83</citedby><cites>FETCH-LOGICAL-c474t-2299b02ac0e22b4ff034f2e123a757046c272941cebb1443707f0fd25a58dda83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6877558/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6877558/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,41096,42165,51551,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31767929$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Samiei, S.</creatorcontrib><creatorcontrib>van Nijnatten, T. J. A.</creatorcontrib><creatorcontrib>van Beek, H. C.</creatorcontrib><creatorcontrib>Polak, M. P. J.</creatorcontrib><creatorcontrib>Maaskant-Braat, A. J. G.</creatorcontrib><creatorcontrib>Heuts, E. M.</creatorcontrib><creatorcontrib>van Kuijk, S. M. J.</creatorcontrib><creatorcontrib>Schipper, R. J.</creatorcontrib><creatorcontrib>Lobbes, M. B. I.</creatorcontrib><creatorcontrib>Smidt, M. L.</creatorcontrib><title>Diagnostic performance of axillary ultrasound and standard breast MRI for differentiation between limited and advanced axillary nodal disease in clinically node-positive breast cancer patients</title><title>Scientific reports</title><addtitle>Sci Rep</addtitle><addtitle>Sci Rep</addtitle><description>Preoperative differentiation between limited (pN1; 1–3 axillary metastases) and advanced (pN2–3; ≥4 axillary metastases) nodal disease can provide relevant information regarding surgical planning and guiding adjuvant radiation therapy. The aim was to evaluate the diagnostic performance of preoperative axillary ultrasound (US) and breast MRI for differentiation between pN1 and pN2–3 in clinically node-positive breast cancer. A total of 49 patients were included with axillary metastasis confirmed by US-guided tissue sampling. All had undergone breast MRI between 2008–2014 and subsequent axillary lymph node dissection. Unenhanced T2-weighted MRI exams were reviewed by two radiologists independently. Each lymph node on the MRI exams was scored using a confidence scale (0–4) and compared with histopathology. Diagnostic performance parameters were calculated for differentiation between pN1 and pN2–3. Interobserver agreement was determined using Cohen’s kappa coefficient. At final histopathology, 67.3% (33/49) and 32.7% (16/49) of patients were pN1 and pN2–3, respectively. Breast MRI was comparable to US in terms of accuracy (MRI reader 1 vs US, 71.4% vs 69.4%, p = 0.99; MRI reader 2 vs US, 73.5% vs 69.4%, p = 0.77). In the case of 1–3 suspicious lymph nodes, pN2–3 was observed in 30.4% on US (positive predictive value (PPV) 69.6%) and in 22.2–24.3% on MRI (PPV 75.7–77.8%). In the case of ≥4 suspicious lymph nodes, pN1 was observed in 33.3% on US (negative predictive value (NPV) 66.7%) and in 38.5–41.7% on MRI (NPV 58.3–61.5%). Interobserver agreement was considered good (k = 0.73). In clinically node-positive patients, the diagnostic performance of axillary US and breast MRI is comparable and limited for accurate differentiation between pN1 and pN2–3. Therefore, there seems no added clinical value of preoperative breast MRI regarding nodal staging in patients with positive axillary US.</description><subject>692/308/409</subject><subject>692/4028/546</subject><subject>Adult</subject><subject>Aged</subject><subject>Axilla - diagnostic imaging</subject><subject>Axilla - pathology</subject><subject>Axilla - surgery</subject><subject>Biopsy</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - diagnostic imaging</subject><subject>Breast Neoplasms - pathology</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>Histopathology</subject><subject>Humanities and Social Sciences</subject><subject>Humans</subject><subject>Lymph Node Excision</subject><subject>Lymph nodes</subject><subject>Lymphatic Metastasis - diagnostic imaging</subject><subject>Lymphatic Metastasis - pathology</subject><subject>Lymphatic system</subject><subject>Magnetic Resonance Imaging</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>multidisciplinary</subject><subject>Observer Variation</subject><subject>Radiation therapy</subject><subject>Radiographic Image Interpretation, Computer-Assisted</subject><subject>Science</subject><subject>Science (multidisciplinary)</subject><subject>Sensitivity and Specificity</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography</subject><subject>Ultrasound</subject><issn>2045-2322</issn><issn>2045-2322</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9UktrFTEUHkSxpfYPuJCAGzejed7MbARprRYqgug6ZDIn15RMck0yV_13_WlmOn3pwkAecL5HzuFrmucEvyaYdW8yJ6LvWkz6VnBMZIsfNYcUc9FSRunjB--D5jjnS1yXoD0n_dPmgBG5kT3tD5urU6e3IebiDNpBsjFNOhhA0SL9y3mv0280-5J0jnMYka47l3rqNKIhgc4FffpyjioPjc5aSBCK08XFgAYoPwEC8m5yBVauHveL_HgvHuKofeXmqgXIBWS8C85o769r0O5idsXt4dbOLAIJ7apJ9crPmidW-wzHN_dR8-3s_deTj-3F5w_nJ-8uWsMlLy2lfT9gqg0GSgduLWbcUiCUaSkk5htD5TIdA8NAOGcSS4vtSIUW3Tjqjh01b1fd3TxMMJrqnbRXu-Sm2oaK2qm_K8F9V9u4V5tOSiEWgVc3Ain-mCEXNblsoE4hQJyzoox0kuF-wyr05T_QyzinUNtbULKvKCEqiq4ok2LOCezdZwhWS0bUmhFVM6KuM6JwJb142MYd5TYRFcBWQK6lsIV07_0f2T_2fMze</recordid><startdate>20191125</startdate><enddate>20191125</enddate><creator>Samiei, S.</creator><creator>van Nijnatten, T. J. A.</creator><creator>van Beek, H. C.</creator><creator>Polak, M. P. J.</creator><creator>Maaskant-Braat, A. J. G.</creator><creator>Heuts, E. M.</creator><creator>van Kuijk, S. M. J.</creator><creator>Schipper, R. J.</creator><creator>Lobbes, M. B. I.</creator><creator>Smidt, M. L.</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>88I</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20191125</creationdate><title>Diagnostic performance of axillary ultrasound and standard breast MRI for differentiation between limited and advanced axillary nodal disease in clinically node-positive breast cancer patients</title><author>Samiei, S. ; van Nijnatten, T. J. A. ; van Beek, H. C. ; Polak, M. P. J. ; Maaskant-Braat, A. J. G. ; Heuts, E. M. ; van Kuijk, S. M. J. ; Schipper, R. J. ; Lobbes, M. B. I. ; Smidt, M. L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-2299b02ac0e22b4ff034f2e123a757046c272941cebb1443707f0fd25a58dda83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>692/308/409</topic><topic>692/4028/546</topic><topic>Adult</topic><topic>Aged</topic><topic>Axilla - diagnostic imaging</topic><topic>Axilla - pathology</topic><topic>Axilla - surgery</topic><topic>Biopsy</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - diagnostic imaging</topic><topic>Breast Neoplasms - pathology</topic><topic>Diagnosis, Differential</topic><topic>Female</topic><topic>Histopathology</topic><topic>Humanities and Social Sciences</topic><topic>Humans</topic><topic>Lymph Node Excision</topic><topic>Lymph nodes</topic><topic>Lymphatic Metastasis - diagnostic imaging</topic><topic>Lymphatic Metastasis - pathology</topic><topic>Lymphatic system</topic><topic>Magnetic Resonance Imaging</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>multidisciplinary</topic><topic>Observer Variation</topic><topic>Radiation therapy</topic><topic>Radiographic Image Interpretation, Computer-Assisted</topic><topic>Science</topic><topic>Science (multidisciplinary)</topic><topic>Sensitivity and Specificity</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Samiei, S.</creatorcontrib><creatorcontrib>van Nijnatten, T. J. A.</creatorcontrib><creatorcontrib>van Beek, H. C.</creatorcontrib><creatorcontrib>Polak, M. P. J.</creatorcontrib><creatorcontrib>Maaskant-Braat, A. J. G.</creatorcontrib><creatorcontrib>Heuts, E. M.</creatorcontrib><creatorcontrib>van Kuijk, S. M. J.</creatorcontrib><creatorcontrib>Schipper, R. J.</creatorcontrib><creatorcontrib>Lobbes, M. B. I.</creatorcontrib><creatorcontrib>Smidt, M. L.</creatorcontrib><collection>Springer Nature OA/Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Scientific reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Samiei, S.</au><au>van Nijnatten, T. J. A.</au><au>van Beek, H. C.</au><au>Polak, M. P. J.</au><au>Maaskant-Braat, A. J. G.</au><au>Heuts, E. M.</au><au>van Kuijk, S. M. J.</au><au>Schipper, R. J.</au><au>Lobbes, M. B. I.</au><au>Smidt, M. L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic performance of axillary ultrasound and standard breast MRI for differentiation between limited and advanced axillary nodal disease in clinically node-positive breast cancer patients</atitle><jtitle>Scientific reports</jtitle><stitle>Sci Rep</stitle><addtitle>Sci Rep</addtitle><date>2019-11-25</date><risdate>2019</risdate><volume>9</volume><issue>1</issue><spage>17476</spage><epage>8</epage><pages>17476-8</pages><artnum>17476</artnum><issn>2045-2322</issn><eissn>2045-2322</eissn><abstract>Preoperative differentiation between limited (pN1; 1–3 axillary metastases) and advanced (pN2–3; ≥4 axillary metastases) nodal disease can provide relevant information regarding surgical planning and guiding adjuvant radiation therapy. The aim was to evaluate the diagnostic performance of preoperative axillary ultrasound (US) and breast MRI for differentiation between pN1 and pN2–3 in clinically node-positive breast cancer. A total of 49 patients were included with axillary metastasis confirmed by US-guided tissue sampling. All had undergone breast MRI between 2008–2014 and subsequent axillary lymph node dissection. Unenhanced T2-weighted MRI exams were reviewed by two radiologists independently. Each lymph node on the MRI exams was scored using a confidence scale (0–4) and compared with histopathology. Diagnostic performance parameters were calculated for differentiation between pN1 and pN2–3. Interobserver agreement was determined using Cohen’s kappa coefficient. At final histopathology, 67.3% (33/49) and 32.7% (16/49) of patients were pN1 and pN2–3, respectively. Breast MRI was comparable to US in terms of accuracy (MRI reader 1 vs US, 71.4% vs 69.4%, p = 0.99; MRI reader 2 vs US, 73.5% vs 69.4%, p = 0.77). In the case of 1–3 suspicious lymph nodes, pN2–3 was observed in 30.4% on US (positive predictive value (PPV) 69.6%) and in 22.2–24.3% on MRI (PPV 75.7–77.8%). In the case of ≥4 suspicious lymph nodes, pN1 was observed in 33.3% on US (negative predictive value (NPV) 66.7%) and in 38.5–41.7% on MRI (NPV 58.3–61.5%). Interobserver agreement was considered good (k = 0.73). In clinically node-positive patients, the diagnostic performance of axillary US and breast MRI is comparable and limited for accurate differentiation between pN1 and pN2–3. Therefore, there seems no added clinical value of preoperative breast MRI regarding nodal staging in patients with positive axillary US.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>31767929</pmid><doi>10.1038/s41598-019-54017-0</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2045-2322 |
| ispartof | Scientific reports, 2019-11, Vol.9 (1), p.17476-8, Article 17476 |
| issn | 2045-2322 2045-2322 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6877558 |
| source | Nature Open Access; MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection; Springer Nature OA/Free Journals; Free Full-Text Journals in Chemistry |
| subjects | 692/308/409 692/4028/546 Adult Aged Axilla - diagnostic imaging Axilla - pathology Axilla - surgery Biopsy Breast cancer Breast Neoplasms - diagnostic imaging Breast Neoplasms - pathology Diagnosis, Differential Female Histopathology Humanities and Social Sciences Humans Lymph Node Excision Lymph nodes Lymphatic Metastasis - diagnostic imaging Lymphatic Metastasis - pathology Lymphatic system Magnetic Resonance Imaging Metastases Metastasis Middle Aged multidisciplinary Observer Variation Radiation therapy Radiographic Image Interpretation, Computer-Assisted Science Science (multidisciplinary) Sensitivity and Specificity Ultrasonic imaging Ultrasonography Ultrasound |
| title | Diagnostic performance of axillary ultrasound and standard breast MRI for differentiation between limited and advanced axillary nodal disease in clinically node-positive breast cancer patients |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-01T19%3A52%3A08IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Diagnostic%20performance%20of%20axillary%20ultrasound%20and%20standard%20breast%20MRI%20for%20differentiation%20between%20limited%20and%20advanced%20axillary%20nodal%20disease%20in%20clinically%20node-positive%20breast%20cancer%20patients&rft.jtitle=Scientific%20reports&rft.au=Samiei,%20S.&rft.date=2019-11-25&rft.volume=9&rft.issue=1&rft.spage=17476&rft.epage=8&rft.pages=17476-8&rft.artnum=17476&rft.issn=2045-2322&rft.eissn=2045-2322&rft_id=info:doi/10.1038/s41598-019-54017-0&rft_dat=%3Cproquest_pubme%3E2317930955%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2317930955&rft_id=info:pmid/31767929&rfr_iscdi=true |