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Akrami, Majid, Sefidbakht, Sepideh, Golchini, Alireza, Ghoddusi Johari, Masoumeh, Shariat, Mehdi, Tahmasebi, Sedigheh, Zangouri, Vahid, Keumarsi, Zahra, Omidi, Ashkan, Mashayekhi, Mohadeseh, Mokhtari, Maral, Talei, Abdolrasoul. (1401). Ultrasound Accuracy in Detection of Metastatic Axillary Lymph Nodes in Breast Cancer after Neoadjuvant Chemotherapy. سامانه مدیریت نشریات علمی, 14(1), 153-161. doi: 10.30476/mejc.2022.90917.1596
Majid Akrami; Sepideh Sefidbakht; Alireza Golchini; Masoumeh Ghoddusi Johari; Mehdi Shariat; Sedigheh Tahmasebi; Vahid Zangouri; Zahra Keumarsi; Ashkan Omidi; Mohadeseh Mashayekhi; Maral Mokhtari; Abdolrasoul Talei. "Ultrasound Accuracy in Detection of Metastatic Axillary Lymph Nodes in Breast Cancer after Neoadjuvant Chemotherapy". سامانه مدیریت نشریات علمی, 14, 1, 1401, 153-161. doi: 10.30476/mejc.2022.90917.1596
Akrami, Majid, Sefidbakht, Sepideh, Golchini, Alireza, Ghoddusi Johari, Masoumeh, Shariat, Mehdi, Tahmasebi, Sedigheh, Zangouri, Vahid, Keumarsi, Zahra, Omidi, Ashkan, Mashayekhi, Mohadeseh, Mokhtari, Maral, Talei, Abdolrasoul. (1401). 'Ultrasound Accuracy in Detection of Metastatic Axillary Lymph Nodes in Breast Cancer after Neoadjuvant Chemotherapy', سامانه مدیریت نشریات علمی, 14(1), pp. 153-161. doi: 10.30476/mejc.2022.90917.1596
Akrami, Majid, Sefidbakht, Sepideh, Golchini, Alireza, Ghoddusi Johari, Masoumeh, Shariat, Mehdi, Tahmasebi, Sedigheh, Zangouri, Vahid, Keumarsi, Zahra, Omidi, Ashkan, Mashayekhi, Mohadeseh, Mokhtari, Maral, Talei, Abdolrasoul. Ultrasound Accuracy in Detection of Metastatic Axillary Lymph Nodes in Breast Cancer after Neoadjuvant Chemotherapy. سامانه مدیریت نشریات علمی, 1401; 14(1): 153-161. doi: 10.30476/mejc.2022.90917.1596

Ultrasound Accuracy in Detection of Metastatic Axillary Lymph Nodes in Breast Cancer after Neoadjuvant Chemotherapy

Middle East Journal of Cancer
مقاله 16، دوره 14، شماره 1 - شماره پیاپی 53، فروردین 2023، صفحه 153-161    اصل مقاله (498.48 K)
نوع مقاله: Original Article(s)
شناسه دیجیتال (DOI): 10.30476/mejc.2022.90917.1596
نویسندگان
Majid Akrami1؛ Sepideh Sefidbakht2؛ Alireza Golchini* 3، 4؛ Masoumeh Ghoddusi Johari1؛ Mehdi Shariat1؛ Sedigheh Tahmasebi1؛ Vahid Zangouri1؛ Zahra Keumarsi1؛ Ashkan Omidi5؛ Mohadeseh Mashayekhi6؛ Maral Mokhtari6؛ Abdolrasoul Talei1
1Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
2Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
3Department of Surgical Oncology Shiraz University of Medical Sciences, Shiraz, Iran
4General Medical Council, London, UK
5School of Medicine, Islamic Azad University of Tehran, Faculty of Medicine, Tehran, Iran
6Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran
چکیده
Background: In the present paper, the main diagnostic tool for re-evaluation of axillary lymph node involvement and planning of surgery after neoadjuvant chemotherapy (NAC) is ultrasound whose accuracy we aimed to determine herein. The high precision of ultrasound in diagnosis of metastatic axillary lymph nodes in untreated patients is well known; however, its worth in patients who received NAC is highly controversial.
Method: We enrolled 165 breast cancer patients receiving NAC in this retrospective cohort study. They all had undergone post-NAC ultrasound done before surgery. The ultrasound reports were reassessed and validated by a breast radiologist. Finally, the histopathology reports were compared to those of the ultrasound.
Results: Among 165 surveyed post-NAC ultrasounds, 53 women had positive results and 112 had negative results. Pathology and ultrasound reports were accordant in 93 women and adverse in 112 others. The false negative rate of post-NAC axillary ultrasound was calculated as 60.6%. The sensitivity and specificity of post-NAC AxUS were 39.4% and 79%, respectively. After NAC, there were certain changes in ultrasound reports from positive to negative in 50% and pathologic complete clearance was observed in just 28% of the women who were initially clinically lymph node positive.
Conclusion: Ultrasound was not found to be an accurate and appropriate tool for evaluation of axillary lymph node involvement in breast cancer patients who receive NAC. By changing the primarily established surgical plan from ALND to SLNB, based on the ultrasound findings, patients may remain undertreated. Furthermore, the axillary nodes pathologic clearance after NAC was observed in less than one third of the women who were initially clinically node positive; accordingly, surgeons should be cautious about the optimum response of axillary metastatic lymph nodes to NAC.
کلیدواژه‌ها
Ultrasound precision؛ NAC؛ Axillary downstaging؛ Lymph node involvement؛ Breast chemotherapy
مراجع
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