Shin Young Kim, Presenter: Nothing to Disclose

Eun Young Ko MD, PhD, Abstract Co-Author: Nothing to Disclose

Boo-Kyung Han MD, PhD, Abstract Co-Author: Nothing to Disclose

Jung Hee Shin MD, Abstract Co-Author: Nothing to Disclose

Jeung Hee Moon, Abstract Co-Author: Nothing to Disclose

Ko Woon Park MD, Abstract Co-Author: Nothing to Disclose

Eun Young Yoo, Abstract Co-Author: Nothing to Disclose

To evaluate the helpful findings for predicting axillary lymph node (LN) metastasis on preoperative breast MRI in the patients with invasive breast cancer.

We retrospectively reviewed the preoperative breast MRI of 192 consecutive patients from January to March 2008, who had definite surgery for invasive breast cancer and axillary LN. Patients with neoadjuvant chemotherapy were excluded from this study. Two radiologists who were blind to the final pathologic results of LN status and primary breast cancer reviewed MR findings of axillary LN focused on size, L/S ratio, cortical thickness, shape and margin of cortex, absence of hilum, asymmetry, and signal intensity on T2-weighted image (WI), degree of early enhancement (DE), and enhancement kinetics. We compared the MR findings between two groups with and without axillary LN metastasis, and evaluated the performance of meaningful MR findings in predicting metastasis. Chi-square test and t-test were used for statistical analysis.

The statistically significant findings for metastatic LN were increased short diameter (p= .000), increased cortical thickness (p= .000), uneven cortex with irregular margin (p= .000), absence of hilum (p= .001), asymmetry (p= .000) and not high signal intensity (SI) on T2WI (p= .016). As we analyzed the cut-off value of short diameter and cortical thickness as 8.05mm and 2.75mm using ROC analysis, the irregular margin, loss of hilum, increased short diameter over 8.05mm showed high specificity (100%, 88%, 77.8%), uneven cortical thickening, cortical thickening more than 2.7mm, and decreased SI on T2WI showed high sensitivity (79.7%, 77.4%, 69.3%). The DE and enhancement kinetics were not different between patients with and without axillary LN metastasis (p= .897, p= .465).  

The morphologic features including uneven cortex, irregular margin, loss of hilum, and decreased SI on T2WI were helpful in predicting metastatic axillary LN on preoperative breast MRI, while enhancement degree or kinetics was not helpful.

We believe that the results of our study could help predicting axillary lymph node metastasis when we interpret the preoperative breast MRI of breast cancer patients.

Kim, S, Ko, E, Han, B, Shin, J, Moon, J, Park, K, Yoo, E, MR Findings Suggesting Metastatic Axillary Lymph Node in Patients with Invasive Breast Cancer  .  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9012244.html