Document Detail


The critical role of axillary ultrasound and aspiration biopsy in the management of breast cancer patients with clinically negative axilla.
MedLine Citation:
PMID:  17680314     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Sonographic evaluation of the axilla can predict node status in a significant proportion of clinically node-negative patients. This review focuses on the value of ultrasound followed by ultrasound-guided cytology in assessing the need for sentinel node mapping and conservative versus complete axillary dissections. DESIGN: Breast primaries from 168 sentinel node candidates were prospectively assessed for clinicopathologic variables associated with increased incidence of axillary metastases. Patients were classified accordingly, and those at a higher risk underwent ultrasound of their axillae, followed by aspiration biopsy if needed. Sentinel node mapping was performed in all low-risk patients, and in high-risk patients with normal axillary ultrasounds or negative cytology. Final axillary status was compared in terms of nodal stage, number of positive nodes, and size of metastasis. RESULTS: 112 patients were at high risk for nodal disease (67%), with a statistically significant lower probability for remaining node-negative and a statistical significantly higher risk for having more than one positive node. All patients with more than three positive nodes were detected by ultrasound-guided cytology. High-risk patients with final positive axillae missed by ultrasound or ultrasound guided cytology had tumor deposits measuring </=5 mm. CONCLUSION: Extent of axillary dissections can be decided based on the risk for axillary metastases: sentinel node mapping for low-risk patients; less-aggressive axillary dissections for high-risk patients with negative ultrasound and/or negative cytology; and a standard dissection for high-risk patients with positive cytology.
Authors:
J L Hinson; P McGrath; A Moore; J T Davis; Y M Brill; E Samoilova; M Cibull; M Hester; E Romond; K Weisinger; L M Samayoa
Related Documents :
22300664 - The phenomenon of "qt stunning": the abnormal qt prolongation provoked by standing pers...
952784 - The management and natural history of severe dysplasia and carcinoma in situ of the ute...
22518124 - Comparison of endocrine profile and in vitro fertilization outcome in patients with pco...
7348844 - Vitreous biopsy in uveitis of unknown cause.
22785214 - Role of blebs and bullae detected by high-resolution computed tomography and recurrent ...
11227964 - A simple method of mapping atrial premature depolarizations triggering atrial fibrillat...
Publication Detail:
Type:  Journal Article     Date:  2007-08-07
Journal Detail:
Title:  Annals of surgical oncology     Volume:  15     ISSN:  1534-4681     ISO Abbreviation:  Ann. Surg. Oncol.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-10     Completed Date:  2008-02-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9420840     Medline TA:  Ann Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  250-5     Citation Subset:  IM    
Affiliation:
Multidisciplinary Breast Cancer Center, University of Kentucky, Lexington, Kentucky, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Axilla / ultrasonography
Biopsy, Fine-Needle / methods*
Breast Neoplasms / surgery*,  ultrasonography
Drainage
Female
Humans
Lymph Nodes
Lymphatic Metastasis
Prospective Studies
Risk Factors
Sentinel Lymph Node Biopsy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Utility of a prognostic nomogram designed for gastric cancer in predicting outcome of patients with ...
Next Document:  Pneumoperitoneum in the cancer patient.