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Diagnostic accuracy of metastatic axillary lymph nodes in breast MRI

PURPOSE: The most important prognostic variable for early stage breast cancer is the status of axillary lymph nodes. The aim of this study was to evaluate the diagnostic accuracy of preoperative magnetic resonance imaging (MRI) for metastatic axillary lymph node in breast cancer cases with post-oper...

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Autores principales: Arslan, Gozde, Altintoprak, Kubra Murzoglu, Yirgin, Inci Kizildag, Atasoy, Mehmet Mahir, Celik, Levent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4909659/
https://www.ncbi.nlm.nih.gov/pubmed/27376003
http://dx.doi.org/10.1186/s40064-016-2419-7
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author Arslan, Gozde
Altintoprak, Kubra Murzoglu
Yirgin, Inci Kizildag
Atasoy, Mehmet Mahir
Celik, Levent
author_facet Arslan, Gozde
Altintoprak, Kubra Murzoglu
Yirgin, Inci Kizildag
Atasoy, Mehmet Mahir
Celik, Levent
author_sort Arslan, Gozde
collection PubMed
description PURPOSE: The most important prognostic variable for early stage breast cancer is the status of axillary lymph nodes. The aim of this study was to evaluate the diagnostic accuracy of preoperative magnetic resonance imaging (MRI) for metastatic axillary lymph node in breast cancer cases with post-operative sentinel lymph node biopsy (SLNB) results. MATERIALS AND METHODS: Women aged between 21 and 73 years who were diagnosed with malignant mass lesion of the breast between 2013 and 2015 were included in this study. The preoperative MR images of patients with diagnosis of breast cancer was evaluated to determine axillary lymph node status. Axillary lymph node size, long axis to short axis ratio, lymph node contours, cortical thickness to anteroposterior diameter ratio, the presence of a fatty hilum and contrast enhancement patterns (homogenous or heterogenous) was noted. Additionally, the presence of comet tail sign which a tail extending from an enhancing breast lesion into the parenchyma and might represent ductal infiltration on post-contrast series was also noted. All data obtained from this evaluation was compared with postoperative SLNB results. RESULTS: Metastatic nodes were found to have a longer short axis when compared to reactive nodes (p = 0.042; p < 0.05). The long axis to short axis ratio was notably lower in metastatic nodes when compared to reactive nodes. Cortical thickness was higher in metastatic nodes when compared to reactive nodes (p = 0.024; p < 0.05). Comet sign was observed in 15 of metastatic nodes (73.3 %) and in one (5 %) reactive node. This difference was statistically significant (p = 0.001; p < 0.01). While fatty hilum was seen in 40 % of metastatic nodes (n = 6), it was seen in all (n = 20) reactive nodes. This difference was statistically significant (p = 0.001; p < 0.01). CONCLUSIONS: MRI is a non invasive sensitive and specific imaging modality for evaluating the axilla. We have shown that with the help of comet tail sign and status of fatty hilum contrast enhanced MRI has the highest sensitivity of 84.7 % for detecting axillary lymph node metastases (Singletary et al. in Semin Surg Oncol 21(1):53–59, 2003).
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spelling pubmed-49096592016-07-01 Diagnostic accuracy of metastatic axillary lymph nodes in breast MRI Arslan, Gozde Altintoprak, Kubra Murzoglu Yirgin, Inci Kizildag Atasoy, Mehmet Mahir Celik, Levent Springerplus Research PURPOSE: The most important prognostic variable for early stage breast cancer is the status of axillary lymph nodes. The aim of this study was to evaluate the diagnostic accuracy of preoperative magnetic resonance imaging (MRI) for metastatic axillary lymph node in breast cancer cases with post-operative sentinel lymph node biopsy (SLNB) results. MATERIALS AND METHODS: Women aged between 21 and 73 years who were diagnosed with malignant mass lesion of the breast between 2013 and 2015 were included in this study. The preoperative MR images of patients with diagnosis of breast cancer was evaluated to determine axillary lymph node status. Axillary lymph node size, long axis to short axis ratio, lymph node contours, cortical thickness to anteroposterior diameter ratio, the presence of a fatty hilum and contrast enhancement patterns (homogenous or heterogenous) was noted. Additionally, the presence of comet tail sign which a tail extending from an enhancing breast lesion into the parenchyma and might represent ductal infiltration on post-contrast series was also noted. All data obtained from this evaluation was compared with postoperative SLNB results. RESULTS: Metastatic nodes were found to have a longer short axis when compared to reactive nodes (p = 0.042; p < 0.05). The long axis to short axis ratio was notably lower in metastatic nodes when compared to reactive nodes. Cortical thickness was higher in metastatic nodes when compared to reactive nodes (p = 0.024; p < 0.05). Comet sign was observed in 15 of metastatic nodes (73.3 %) and in one (5 %) reactive node. This difference was statistically significant (p = 0.001; p < 0.01). While fatty hilum was seen in 40 % of metastatic nodes (n = 6), it was seen in all (n = 20) reactive nodes. This difference was statistically significant (p = 0.001; p < 0.01). CONCLUSIONS: MRI is a non invasive sensitive and specific imaging modality for evaluating the axilla. We have shown that with the help of comet tail sign and status of fatty hilum contrast enhanced MRI has the highest sensitivity of 84.7 % for detecting axillary lymph node metastases (Singletary et al. in Semin Surg Oncol 21(1):53–59, 2003). Springer International Publishing 2016-06-16 /pmc/articles/PMC4909659/ /pubmed/27376003 http://dx.doi.org/10.1186/s40064-016-2419-7 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Research
Arslan, Gozde
Altintoprak, Kubra Murzoglu
Yirgin, Inci Kizildag
Atasoy, Mehmet Mahir
Celik, Levent
Diagnostic accuracy of metastatic axillary lymph nodes in breast MRI
title Diagnostic accuracy of metastatic axillary lymph nodes in breast MRI
title_full Diagnostic accuracy of metastatic axillary lymph nodes in breast MRI
title_fullStr Diagnostic accuracy of metastatic axillary lymph nodes in breast MRI
title_full_unstemmed Diagnostic accuracy of metastatic axillary lymph nodes in breast MRI
title_short Diagnostic accuracy of metastatic axillary lymph nodes in breast MRI
title_sort diagnostic accuracy of metastatic axillary lymph nodes in breast mri
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4909659/
https://www.ncbi.nlm.nih.gov/pubmed/27376003
http://dx.doi.org/10.1186/s40064-016-2419-7
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