E-ISSN 2367-699X | ISSN 2367-7414
 

Original Research (Original Article) 


CLINICOPATHOLOGICAL FACTORS ASSOCIATED WITH POSITIVE PREOPERATIVE AXILLARY ULTRASOUND SCANNING IN BREAST CANCER PATIENTS

Lona Jalini, Dave Fok Nam Fung, Kaushik Kumar Dasgupta, Vijay Kurup.

Cited by (1)

Abstract
Background: Axillary lymph node status is the most important breast cancer prognostic factor. Preoperative axillary ultrasound examination (PAUS) is used to triage patients for sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). We assessed the detection rate of lymph node metastases by PAUS in a screening unit and evaluated associations between clinicopathological factors and PAUS positivity.
Patients and Methods: This was a single-centre retrospective analysis of data extracted from a hospital breast cancer database and clinical records. Clinical, radiological, and pathological and prognostic indices were compared between PAUS-positive and PAUS-negative patients subsequently found to have lymph node metastases on histopathological analysis.
Results: Two hundred and two patients were eligible for analysis. 50.5% of lymph node-positive patients were correctly identified as PAUS positive. Patients with PAUS-positive lymph nodes had less favorable disease characteristics, namely clinically palpable lymph nodes, higher Nottingham prognostic (NPI) index, high lymph node burden according to the European Society of Medical Oncology (ESMO) group classification, and larger, grade 3 tumors with lymphovascular invasion and extranodal spread. Moreover, PAUS-positive patients had more macrometastases and lymph node involvement than PAUS-negative patients.
Conclusion: PAUS-positive patients and PAUS-negative (SLNB-positive) patients have different clinicopathological characteristics. The presence of LVI, extranodal spread, grade 3 histology, or large tumors with poor prognostic indices in PAUS-negative patients should be regarded with caution and perhaps prompt second-look ultrasound examination.

Key words: Preoperative axillary ultrasound scan; sentinel lymph node biopsy; breast cancer


 
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REFERENCES
1. Fisher B, Bauer M, Wickerham DL, Redmond CK, Fisher ER, Cruz AB, Foster R, Gardner B, Lerner H, Margolese R, et al. Relation of a number of positive axillary nodes to the prognosis of patients with primary breast cancer. An NSABP update. Cancer 1983;52:1551-1557. [DOI via Crossref]   
2. Thomssen C, Janicke F, Harbeck N. Clinical relevance of prognostic factors in axillary node-negative breast cancer. Onkologie 2003;26:438-445. [DOI via Crossref]    [Pubmed]   
3. Evans A, Rauchhaus P, Whelehan P, Thomson K, Purdie CA, Jordan LB, Michie CO, Thompson A, Vinnicombe S. Does shear wave ultrasound independently predict axillary lymph node metastasis in women with invasive breast cancer? Breast Cancer Res Treat 2014;143:153-157.
4. Cooper KL, Meng Y, Harnan S, Ward SE, Fitzgerald P, Papaioannou D, Wyld L, Ingram C, Wilkinson ID, Lorenz E. Positron emission tomography (PET) and magnetic resonance imaging (MRI) for the assessment of axillary lymph node metastases in early breast cancer: Systematic review and economic evaluation. Health Technol Assess 2011;15:iii-iv, 1-134.
5. Harnett A, Smallwood J, Titshall V, Champion A. Diagnosis and treatment of early breast cancer, including locally advanced disease--summary of nice guidance. BMJ 2009;338:b438.
6. Rajesh YS, Ellenbogen S, Banerjee B. Preoperative axillary ultrasound scan: Its accuracy in assessing the axillary nodal status in carcinoma breast. Breast 2002;11:49-52. [DOI via Crossref]    [Pubmed]   
7. Specht MC, Fey JV, Borgen PI, Cody HS, 3rd. Is the clinically positive axilla in breast cancer really a contraindication to sentinel lymph node biopsy? J Am Coll Surg 2005;200:10-14.
8. Blamey RW, Ellis IO, Pinder SE, Lee AH, Macmillan RD, Morgan DA, Robertson JF, Mitchell MJ, Ball GR, Haybittle JL, Elston CW. Survival of invasive breast cancer according to the Nottingham Prognostic Index in cases diagnosed in 1990-1999. Eur J Cancer 2007;43(10):1548–1555. [DOI via Crossref]    [Pubmed]   
9. Kataja V, Castiglione M. Primary breast cancer: ESMO Clinical Recommendations for diagnosis, treatment and follow. Ann Oncol 2009;20(4):10-4. [DOI via Crossref]   
10. Wolff AC, Hammond ME, Schwartz JN, Hagerty KL, et al. Recommendations for human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline update. J Clin Oncol. 2013;31(31):3997-4013. [DOI via Crossref]    [Pubmed]   
11. van Wely BJ, de Wilt JH, Francissen C, Teerenstra S, Strobbe LJ. Meta-analysis of ultrasound-guided biopsy of suspicious axillary lymph nodes in the selection of patients with extensive axillary tumour burden in breast cancer. Br J Surg 2015;102:159-168. [DOI via Crossref]    [Pubmed]   
12. Ertan K, Linsler C, Di Liberto A, Ong MF, Solomayer E, Endrikat J. Axillary ultrasound for breast cancer staging: an attempt to identify clinical/histopathological factors impacting diagnostic performance. Breast Cancer (Auckl) 2013;7:35-40.
13. Verheuvel NC, van den Hoven I, Ooms HW, Voogd AC, Roumen RM. The role of ultrasound-guided lymph node biopsy in axillary staging of invasive breast cancer in the post-ACOSOG Z0011 trial era. Ann Surg Oncol 2015;22:409-415. [DOI via Crossref]    [Pubmed]   
14. van Wely BJ, de Wilt JH, Schout PJ, Kooistra B, Wauters CA, Venderinck D, Strobbe LJ. Ultrasound-guided fine-needle aspiration of suspicious nodes in breast cancer patients; selecting patients with extensive nodal involvement. Breast Cancer Res Treat 2013;140:113-118. [DOI via Crossref]    [Pubmed]   
15. Diepstraten SC, Sever AR, Buckens CF, Veldhuis WB, van Dalen T, van den Bosch MA, Mali WP, Verkooijen HM. Value of preoperative ultrasound-guided axillary lymph node biopsy for preventing completion axillary lymph node dissection in breast cancer: A systematic review and meta-analysis. Ann Surg Oncol 2014;21:51-59. [DOI via Crossref]    [Pubmed]   
16. Pesce C, Morrow M. The need for lymph node dissection in nonmetastatic breast cancer. Annu Rev Med 2013;64:119-129. [DOI via Crossref]    [Pubmed]   
17. Houssami N, Diepstraten SC, Cody HS, 3rd, Turner RM, Sever AR. Clinical utility of ultrasound-needle biopsy for preoperative staging of the axilla in invasive breast cancer. Anticancer Res 2014;34:1087-1097.
18. Houssami N, Ciatto S, Turner RM, Cody HS, 3rd, Macaskill P. Preoperative ultrasound-guided needle biopsy of axillary nodes in invasive breast cancer: Meta-analysis of its accuracy and utility in staging the axilla. Ann Surg 2011;254:243-251. [DOI via Crossref]    [Pubmed]   
19. Schipper RJ, van Roozendaal LM, de Vries B, Pijnappel RM, Beets-Tan RG, Lobbes MB, Smidt ML. Axillary ultrasound for preoperative nodal staging in breast cancer patients: Is it of added value? Breast 2013;22:1108-1113.
20. Lee MC, Eatrides J, Chau A, Han G, Kiluk JV, Khakpour N, Cox CE, Carter WB, Laronga C. Consequences of axillary ultrasound in patients with T2 or greater invasive breast cancers. Ann Surg Oncol 2011;18:72-77. [DOI via Crossref]    [Pubmed]   
21. Swinson C, Ravichandran D, Nayagam M, Allen S. Ultrasound and fine needle aspiration cytology of the axilla in the pre-operative identification of axillary nodal involvement in breast cancer. Eur J Surg Oncol 2009;35:1152-1157. [DOI via Crossref]    [Pubmed]   
22. Xu G, Han T, Yao MH, Xie J, Xu HX, Wu R. Three-dimensional ultrasonography for the prediction of breast cancer prognosis. J Buon 2014;19:643-649.
23. Amonkar SJ, Oates E, McLean L, Nicholson S. Pre-operative staging of the axilla in primary breast cancer. By redefining the abnormal appearing node, can we reduce investigations without affecting overall treatment? Breast 2013;22:1114-1118.
24. Britton P, Moyle P, Benson JR, Goud A, Sinnatamby R, Barter S, Gaskarth M, Provenzano E, Wallis M. Ultrasound of the axilla: Where to look for the sentinel lymph node. Clin Radiol 2010;65:373-376. [DOI via Crossref]    [Pubmed]   
25. Sever A, Jones S, Cox K, Weeks J, Mills P, Jones P. Preoperative localization of sentinel lymph nodes using intradermal microbubbles and contrast-enhanced ultrasonography in patients with breast cancer. Br J Surg 2009;96:1295-1299. [DOI via Crossref]    [Pubmed]   
26. Sever AR, Mills P, Jones SE, Cox K, Weeks J, Fish D, Jones PA. Preoperative sentinel node identification with ultrasound using microbubbles in patients with breast cancer. AJR Am J Roentgenol 2011;196:251-256. [DOI via Crossref]    [Pubmed]   

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How to Cite this Article
Pubmed Style

Lona Jalini, Dave Fok Nam Fung, Kaushik Kumar Dasgupta, Vijay Kurup. CLINICOPATHOLOGICAL FACTORS ASSOCIATED WITH POSITIVE PREOPERATIVE AXILLARY ULTRASOUND SCANNING IN BREAST CANCER PATIENTS. Int J Surg Med. 2016; 2(1): 23-29. doi:10.5455/ijsm.breastcancer


Web Style

Lona Jalini, Dave Fok Nam Fung, Kaushik Kumar Dasgupta, Vijay Kurup. CLINICOPATHOLOGICAL FACTORS ASSOCIATED WITH POSITIVE PREOPERATIVE AXILLARY ULTRASOUND SCANNING IN BREAST CANCER PATIENTS. http://www.ejos.org/?mno=208901 [Access: December 11, 2019]. doi:10.5455/ijsm.breastcancer


AMA (American Medical Association) Style

Lona Jalini, Dave Fok Nam Fung, Kaushik Kumar Dasgupta, Vijay Kurup. CLINICOPATHOLOGICAL FACTORS ASSOCIATED WITH POSITIVE PREOPERATIVE AXILLARY ULTRASOUND SCANNING IN BREAST CANCER PATIENTS. Int J Surg Med. 2016; 2(1): 23-29. doi:10.5455/ijsm.breastcancer



Vancouver/ICMJE Style

Lona Jalini, Dave Fok Nam Fung, Kaushik Kumar Dasgupta, Vijay Kurup. CLINICOPATHOLOGICAL FACTORS ASSOCIATED WITH POSITIVE PREOPERATIVE AXILLARY ULTRASOUND SCANNING IN BREAST CANCER PATIENTS. Int J Surg Med. (2016), [cited December 11, 2019]; 2(1): 23-29. doi:10.5455/ijsm.breastcancer



Harvard Style

Lona Jalini, Dave Fok Nam Fung, Kaushik Kumar Dasgupta, Vijay Kurup (2016) CLINICOPATHOLOGICAL FACTORS ASSOCIATED WITH POSITIVE PREOPERATIVE AXILLARY ULTRASOUND SCANNING IN BREAST CANCER PATIENTS. Int J Surg Med, 2 (1), 23-29. doi:10.5455/ijsm.breastcancer



Turabian Style

Lona Jalini, Dave Fok Nam Fung, Kaushik Kumar Dasgupta, Vijay Kurup. 2016. CLINICOPATHOLOGICAL FACTORS ASSOCIATED WITH POSITIVE PREOPERATIVE AXILLARY ULTRASOUND SCANNING IN BREAST CANCER PATIENTS. International Journal of Surgery and Medicine, 2 (1), 23-29. doi:10.5455/ijsm.breastcancer



Chicago Style

Lona Jalini, Dave Fok Nam Fung, Kaushik Kumar Dasgupta, Vijay Kurup. "CLINICOPATHOLOGICAL FACTORS ASSOCIATED WITH POSITIVE PREOPERATIVE AXILLARY ULTRASOUND SCANNING IN BREAST CANCER PATIENTS." International Journal of Surgery and Medicine 2 (2016), 23-29. doi:10.5455/ijsm.breastcancer



MLA (The Modern Language Association) Style

Lona Jalini, Dave Fok Nam Fung, Kaushik Kumar Dasgupta, Vijay Kurup. "CLINICOPATHOLOGICAL FACTORS ASSOCIATED WITH POSITIVE PREOPERATIVE AXILLARY ULTRASOUND SCANNING IN BREAST CANCER PATIENTS." International Journal of Surgery and Medicine 2.1 (2016), 23-29. Print. doi:10.5455/ijsm.breastcancer



APA (American Psychological Association) Style

Lona Jalini, Dave Fok Nam Fung, Kaushik Kumar Dasgupta, Vijay Kurup (2016) CLINICOPATHOLOGICAL FACTORS ASSOCIATED WITH POSITIVE PREOPERATIVE AXILLARY ULTRASOUND SCANNING IN BREAST CANCER PATIENTS. International Journal of Surgery and Medicine, 2 (1), 23-29. doi:10.5455/ijsm.breastcancer