Aims and objectives
Breast cancer is the most common malignant tumor in women after non-melanocytic skin cancer and the leading cause of cancer death among them[1].
Locally advanced breast cancer constitutes a heterogeneous entity that includes advanced-stage primary tumors,
cancers with extensive locoregional nodal involvement (axillary,
supraclavicular or internal mammary nodes),
cancers that involve the skin or the underlying muscles of the chest and inflammatory breast carcinomas[2].
Axillary nodal status is the most important prognostic factor for patients with breast cancer,
so axillary lymph node evaluation is essential[3]....
Methods and materials
We conducted a retrospective study of 114 patients with LADBC that received neoadjuvant treatment in our institution between 2011 and 2017 ( Fig. 1 ).
Initial axillary lymph node sonographic evaluation was conducted in all patients.
Six different radiologists evaluated the axillary status.
Nodal features assessed were the shape and the morphology of the cortex and lymph nodes were classificated according to Bedi’s criteria into positive (types 5 and 6) or negative (types 1-4).
When pathologic lymph nodes were detected,
a core needle biopsy (CNB)...
Results
All patients were between 26 and 74 years of age.
Axillary lymph node involvement at diagnosis was found in 91 patients (79.8%) either by ultrasound-guided biopsy or SLNB.
The AU was pathological in 81 cases (71%),
with histological confirmation in 76 (93.8%).
In 33 cases,
ultrasonography did not find any pathological result.
However,
15 of these 33 patients (45.5%) with normal AU who underwent SLNB had histologically confirmed lymph node disease (these results are reported in Fig. 1 ).
The results of axillary ultrasound before...
Conclusion
According to available literature,
axillary ultrasound has a low negative predictive value and negative ultrasound results do not exclude axillary node metastases with sufficient sensitivity to justify its use as isolated tool to evaluate axillary involvement.The main limitation of AU is the detection of micrometastases.
Therefore,
when negative AU,
SLNB is mandatory.
In our cohort study,
ultrasound is useful for the initial assessment of pretreatment axillary lymph node.
AU has a fundamental role to play in the initial diagnosis and staging of LADBC,
however it...
References
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