High-resolution ultrasonographic features of axillary lymph node metastasis in patients with breast cancer
Yoon Jung Choi, Eun Young Ko, Boo-Kyung Han, Jung Hee Shin, Seok Seon Kang, Soo Yeon Hahn
The Breast 18 (2009) 119–122
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US features known to accurately predict metastasis in axillary lymph nodes could be used at the time of the preoperative breast US to determine the need for FNA, SLN or ALND. Results of the present study indicate that a cortical thickness greater than 3 mm is the most reliable US feature predicting a metastasis, with sensitivity, specificity, PPV and NPV around 70%. For the L/S ratio, those parameters were only 52–65% accurate
Recent advances in high-resolution US allow examination of more detailed features of lymph nodes, such as cortex shape and internal hilar echogenicity, which may prove to be useful indicators of metastasis. Our results showed that the absence of a hilum had high specificity, but low sensitivity. Previous studies found that a hyperechogenic hilum indicated a benign lymph node, and loss of normal echogenicity had moderate to high specificity for metastasis
Wednesday, 22 April 2009
Predicting the status of axillary lymph nodes in breast cancer: A multiparameter approach including axillary ultrasound scanning
Predicting the status of axillary lymph nodes in breast cancer: A multiparameter approach including axillary ultrasound scanning
Tommaso Susini, Jacopo Nori, Simone Olivieri, Cecilia Molino, Giulia Marini, Simonetta Bianchi, Vania Vezzosi, Lorenzo Livi, Mario Mascalchi, Gianfranco Scarselli
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Axillary US along with tumor site within the breast and Ki-67 proliferation index allowed reliable prediction of axillary metastases risk. These findings still require prospective validation in a larger sample of women. If our preliminary results will be confirmed, this multiparameter evaluation may be used to optimize the selection of breast cancer patients candidate to sentinel lymph node biopsy or axillary lymph node dissection
Tommaso Susini, Jacopo Nori, Simone Olivieri, Cecilia Molino, Giulia Marini, Simonetta Bianchi, Vania Vezzosi, Lorenzo Livi, Mario Mascalchi, Gianfranco Scarselli
Link to Journal
Axillary US along with tumor site within the breast and Ki-67 proliferation index allowed reliable prediction of axillary metastases risk. These findings still require prospective validation in a larger sample of women. If our preliminary results will be confirmed, this multiparameter evaluation may be used to optimize the selection of breast cancer patients candidate to sentinel lymph node biopsy or axillary lymph node dissection
Patient-led breast cancer follow up
Patient-led breast cancer follow up
D. Chapman, E. Cox, P.D. Britton, G.C. Wishart
The Breast 2009 18 (2): 100-102
Link to Journal
The introduction of PLFU has been well received by patients at low risk of breast cancer recurrence or death without a marked increase in GP workload. The use of risk stratification allows low risk patients to undergo five-year mammographic surveillance without regular breast examination but with access to clinical input if necessary. It also allows time to be spent with those patients at higher risk of recurrence as well as an increasing flow of new referrals with symptomatic disease.
Introduction of this model will comply with NICE guidelines to reduce unnecessary breast cancer follow up and contribute to UK breast units achieving the government target to see all breast cancer referrals within two weeks in the near future. The introduction of PLFU should therefore be considered by all breast units in the UK
D. Chapman, E. Cox, P.D. Britton, G.C. Wishart
The Breast 2009 18 (2): 100-102
Link to Journal
The introduction of PLFU has been well received by patients at low risk of breast cancer recurrence or death without a marked increase in GP workload. The use of risk stratification allows low risk patients to undergo five-year mammographic surveillance without regular breast examination but with access to clinical input if necessary. It also allows time to be spent with those patients at higher risk of recurrence as well as an increasing flow of new referrals with symptomatic disease.
Introduction of this model will comply with NICE guidelines to reduce unnecessary breast cancer follow up and contribute to UK breast units achieving the government target to see all breast cancer referrals within two weeks in the near future. The introduction of PLFU should therefore be considered by all breast units in the UK
Ultrasound-guided vacuum assisted breast biopsy in the assessment of C3 breast lesions by ultrasound-guided fine needle aspiration cytology: Results a
Ultrasound-guided vacuum assisted breast biopsy in the assessment of C3 breast lesions by ultrasound-guided fine needle aspiration cytology: Results and costs in comparison with surgery
Francesca Abbate, Lorenzo Bacigalupo, Antuono Latronico, Chiara Trentin, Silvia Penco, Simona Menna, Giuseppe Viale, Enrico Cassano, Massimo Bellomi
The Breast 2009, 18 (2):73-77
Link to Journal
In our experience, US-guided VABB appears to be an accurate and cost-effective modality compared to surgery for the evaluation of lesions which are found to be C3 (indeterminate) at US-guided FNAC. In particular, considering the low percentage of malignant cases in this series (18/138 = 13%), surgical biopsy may be avoided in most cases. This diagnostic approach would allow surgery to be restricted to the treatment to malignant lesions and, in a few selected patients, to confirm or further investigate VABB findings.
Still the choice of using VABB to assess US visible C3 lesions might be excessive as core biopsy might be used as an alternative, more studies comparing VABB and core biopsy to assess C3 cases are needed before VABB may be recommended as the ideal option
Francesca Abbate, Lorenzo Bacigalupo, Antuono Latronico, Chiara Trentin, Silvia Penco, Simona Menna, Giuseppe Viale, Enrico Cassano, Massimo Bellomi
The Breast 2009, 18 (2):73-77
Link to Journal
In our experience, US-guided VABB appears to be an accurate and cost-effective modality compared to surgery for the evaluation of lesions which are found to be C3 (indeterminate) at US-guided FNAC. In particular, considering the low percentage of malignant cases in this series (18/138 = 13%), surgical biopsy may be avoided in most cases. This diagnostic approach would allow surgery to be restricted to the treatment to malignant lesions and, in a few selected patients, to confirm or further investigate VABB findings.
Still the choice of using VABB to assess US visible C3 lesions might be excessive as core biopsy might be used as an alternative, more studies comparing VABB and core biopsy to assess C3 cases are needed before VABB may be recommended as the ideal option
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