Hiroyuki Abe MD, Presenter: Nothing to Disclose

Robert Albert Schmidt MD, Abstract Co-Author: Stockholder, Hologic, Inc, Los Altos, CA Research grant, FUJIFILM Holdings Corporation, Stamford, CT Research grant, Konica Minolta Group Consultant, Konica Minolta Group Advisory Board, Konica Minolta Group Spouse, research grant, Koninklijke Philips Electronics NV Spouse, Speakers Bureau, Bayer AG

Lina Arbash Meinel PhD, Abstract Co-Author: Employee, Koninklijke Philips Electronics NV

Akiko Shimauchi MD, Abstract Co-Author: Nothing to Disclose

Charlene A. Sennett MD, Abstract Co-Author: Nothing to Disclose

Gillian Maclaine Newstead MD, Abstract Co-Author: Consultant, Naviscan Inc Consultant, Three Palm Software LLC Research suppport, Koninklijke Philips Electronics NV Spouse, stockholder, Hologic, Inc

Kirti Manohar Kulkarni MBBS, Abstract Co-Author: Nothing to Disclose

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

To study the clinical utility of ultrasound study for axilla to detect abnormal lymph nodes for staging breast cancer.

Ultrasound study for ipsilateral axilla is routinely performed for patients withbreast cancer and suspicious lesionsin our instituion. Retrospective study was made of 441 patients with proven breast cancer who underwent ipsilateral axillary ultrasound between January 2005 and December 2007. There were 402 patients with invasive cancer and 39 patients with extensive DCIS. When suspicious lymph node(s)was detected, ultrasound guided core biopsy (USCB)was performed. When ultrasound did not detect suspicious lymph node or negative result was obtained with USCB, a sentinel lymph node biopsy (SLNB) was performed.

Ultrasound detected suspicious lymph node(s) in 133 patients. In these patients, USCB was performed for 131 patientswith73 positive results, and SLNB was performed for 60 patients revealing8 positive nodes.Asfor 308 patients with negative ultrasound, negative SLNB was obtained in 251 patients (247 with negative for metasitasis, and 4 with isolated tumor cluster), and matastatic nodes were foundwith SLNB in 57 patients, including 24 micrometasitasis. Overall, sensitivity, specificity, positivepredictive value (PPV) and negative predictive value (NPV)are 59%, 83 %, 62 % and 82%. In 57 false negative patients, there are 24 (42%) micrometastasis, 16 (28%) metastatic depositsno more than 5 mm, 16 (28%)metastatic deposits more than 5 mm, and1 with unknown size.USCBobviated the need for a SLNBin diagnosis of metastatic lymph node in 53 % (73/133).

Our data suggest that ultrasound is useful for lymph node staging of breast cancer as it detected positive node(s) in morethan half of patients with metastatic lymph node(s) (59%, 81/138).Ultrasound guided biopsy is recommended whensuspicious lymph node is detected, as positive biopsy result will helpavoiding a time-consuming and expensive SLNB.A netative ultrasoundresult of axillary scanning still necessitates a SLNB.

Ultrasound is useful for lymph node staging of breast cancer, and ultrasound guided biopsy is recommended when suspicious lymph node is detected, as positive biopsy result will obviate SLNB.

Abe, H, Schmidt, R, Arbash Meinel, L, Shimauchi, A, Sennett, C, Newstead, G, Kulkarni, K, et al, 0, Value of Ultrasound for Axillary Lymph Node Staging of Breast Cancer Patients.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8002418.html