A comparison of the diagnostic accuracy of magnetic resonance imaging to axillary ultrasound in the detection of axillary nodal metastases in newly diagnosed breast cancer

Matthew A. Assing, Bhavika Patel, Neel Karamsadkar, Jared Weinfurtner, Omar Usmani, John V. Kiluk, Jennifer S. Drukteinis

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Patients with a diagnosis of invasive breast cancer are increasingly undergoing breast magnetic resonance imaging (MRI) for preoperative staging including evaluation of axillary lymph node metastases (ALNM). This retrospective study aims to evaluate the utility of adding axillary ultrasound (AUS) in the preoperative setting when an MRI is planned or has already been performed. This IRB approved, HIPAA compliant study reviewed a total of 271 patients with a new diagnosis of invasive breast cancer at a single institution, between June 1, 2010 and June 30, 2013. The study included patients who received both AUS and MRI for preoperative staging. Data were divided into two cohorts, patients who underwent MRI prior to AUS and those who underwent AUS prior to MRI. AUS and MRI reports were categorized according to BI-RADS criteria as “suspicious” or “not suspicious” for ALNM. In the setting of a negative MRI and subsequent positive AUS, only one out of 25 cases (4%) were positive for metastases after correlating with histologic pathology. MRI detected metastatic disease in four out of 27 (15%) patients who had false-negative AUS performed prior to MRI. Our results indicate the addition of AUS after preoperative MRI does not contribute significantly to increased detection of missed disease. MRI could serve as the initial staging imaging method of the axilla in the setting that AUS is not initially performed and may be valuable in identification of lymph nodes not identified on AUS.

Original languageEnglish (US)
Pages (from-to)647-655
Number of pages9
JournalBreast Journal
Volume23
Issue number6
DOIs
StatePublished - Nov 1 2017

Fingerprint

Magnetic Resonance Imaging
Breast Neoplasms
Neoplasm Metastasis
Lymph Nodes
Health Insurance Portability and Accountability Act
Axilla
Research Ethics Committees
Breast
Retrospective Studies
Pathology

Keywords

  • breast cancer
  • lymph nodes
  • metastasis
  • MRI
  • ultrasound

ASJC Scopus subject areas

  • Internal Medicine
  • Surgery
  • Oncology

Cite this

A comparison of the diagnostic accuracy of magnetic resonance imaging to axillary ultrasound in the detection of axillary nodal metastases in newly diagnosed breast cancer. / Assing, Matthew A.; Patel, Bhavika; Karamsadkar, Neel; Weinfurtner, Jared; Usmani, Omar; Kiluk, John V.; Drukteinis, Jennifer S.

In: Breast Journal, Vol. 23, No. 6, 01.11.2017, p. 647-655.

Research output: Contribution to journalArticle

Assing, Matthew A. ; Patel, Bhavika ; Karamsadkar, Neel ; Weinfurtner, Jared ; Usmani, Omar ; Kiluk, John V. ; Drukteinis, Jennifer S. / A comparison of the diagnostic accuracy of magnetic resonance imaging to axillary ultrasound in the detection of axillary nodal metastases in newly diagnosed breast cancer. In: Breast Journal. 2017 ; Vol. 23, No. 6. pp. 647-655.
@article{5eae3426611e442591ce94e984e030e1,
title = "A comparison of the diagnostic accuracy of magnetic resonance imaging to axillary ultrasound in the detection of axillary nodal metastases in newly diagnosed breast cancer",
abstract = "Patients with a diagnosis of invasive breast cancer are increasingly undergoing breast magnetic resonance imaging (MRI) for preoperative staging including evaluation of axillary lymph node metastases (ALNM). This retrospective study aims to evaluate the utility of adding axillary ultrasound (AUS) in the preoperative setting when an MRI is planned or has already been performed. This IRB approved, HIPAA compliant study reviewed a total of 271 patients with a new diagnosis of invasive breast cancer at a single institution, between June 1, 2010 and June 30, 2013. The study included patients who received both AUS and MRI for preoperative staging. Data were divided into two cohorts, patients who underwent MRI prior to AUS and those who underwent AUS prior to MRI. AUS and MRI reports were categorized according to BI-RADS criteria as “suspicious” or “not suspicious” for ALNM. In the setting of a negative MRI and subsequent positive AUS, only one out of 25 cases (4{\%}) were positive for metastases after correlating with histologic pathology. MRI detected metastatic disease in four out of 27 (15{\%}) patients who had false-negative AUS performed prior to MRI. Our results indicate the addition of AUS after preoperative MRI does not contribute significantly to increased detection of missed disease. MRI could serve as the initial staging imaging method of the axilla in the setting that AUS is not initially performed and may be valuable in identification of lymph nodes not identified on AUS.",
keywords = "breast cancer, lymph nodes, metastasis, MRI, ultrasound",
author = "Assing, {Matthew A.} and Bhavika Patel and Neel Karamsadkar and Jared Weinfurtner and Omar Usmani and Kiluk, {John V.} and Drukteinis, {Jennifer S.}",
year = "2017",
month = "11",
day = "1",
doi = "10.1111/tbj.12812",
language = "English (US)",
volume = "23",
pages = "647--655",
journal = "Breast Journal",
issn = "1075-122X",
publisher = "Wiley-Blackwell",
number = "6",

}

TY - JOUR

T1 - A comparison of the diagnostic accuracy of magnetic resonance imaging to axillary ultrasound in the detection of axillary nodal metastases in newly diagnosed breast cancer

AU - Assing, Matthew A.

AU - Patel, Bhavika

AU - Karamsadkar, Neel

AU - Weinfurtner, Jared

AU - Usmani, Omar

AU - Kiluk, John V.

AU - Drukteinis, Jennifer S.

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Patients with a diagnosis of invasive breast cancer are increasingly undergoing breast magnetic resonance imaging (MRI) for preoperative staging including evaluation of axillary lymph node metastases (ALNM). This retrospective study aims to evaluate the utility of adding axillary ultrasound (AUS) in the preoperative setting when an MRI is planned or has already been performed. This IRB approved, HIPAA compliant study reviewed a total of 271 patients with a new diagnosis of invasive breast cancer at a single institution, between June 1, 2010 and June 30, 2013. The study included patients who received both AUS and MRI for preoperative staging. Data were divided into two cohorts, patients who underwent MRI prior to AUS and those who underwent AUS prior to MRI. AUS and MRI reports were categorized according to BI-RADS criteria as “suspicious” or “not suspicious” for ALNM. In the setting of a negative MRI and subsequent positive AUS, only one out of 25 cases (4%) were positive for metastases after correlating with histologic pathology. MRI detected metastatic disease in four out of 27 (15%) patients who had false-negative AUS performed prior to MRI. Our results indicate the addition of AUS after preoperative MRI does not contribute significantly to increased detection of missed disease. MRI could serve as the initial staging imaging method of the axilla in the setting that AUS is not initially performed and may be valuable in identification of lymph nodes not identified on AUS.

AB - Patients with a diagnosis of invasive breast cancer are increasingly undergoing breast magnetic resonance imaging (MRI) for preoperative staging including evaluation of axillary lymph node metastases (ALNM). This retrospective study aims to evaluate the utility of adding axillary ultrasound (AUS) in the preoperative setting when an MRI is planned or has already been performed. This IRB approved, HIPAA compliant study reviewed a total of 271 patients with a new diagnosis of invasive breast cancer at a single institution, between June 1, 2010 and June 30, 2013. The study included patients who received both AUS and MRI for preoperative staging. Data were divided into two cohorts, patients who underwent MRI prior to AUS and those who underwent AUS prior to MRI. AUS and MRI reports were categorized according to BI-RADS criteria as “suspicious” or “not suspicious” for ALNM. In the setting of a negative MRI and subsequent positive AUS, only one out of 25 cases (4%) were positive for metastases after correlating with histologic pathology. MRI detected metastatic disease in four out of 27 (15%) patients who had false-negative AUS performed prior to MRI. Our results indicate the addition of AUS after preoperative MRI does not contribute significantly to increased detection of missed disease. MRI could serve as the initial staging imaging method of the axilla in the setting that AUS is not initially performed and may be valuable in identification of lymph nodes not identified on AUS.

KW - breast cancer

KW - lymph nodes

KW - metastasis

KW - MRI

KW - ultrasound

UR - http://www.scopus.com/inward/record.url?scp=85017535783&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85017535783&partnerID=8YFLogxK

U2 - 10.1111/tbj.12812

DO - 10.1111/tbj.12812

M3 - Article

VL - 23

SP - 647

EP - 655

JO - Breast Journal

JF - Breast Journal

SN - 1075-122X

IS - 6

ER -