ArticleScientific reports2019
Diagnostic performance of axillary ultrasound and standard breast MRI for differentiation between limited and advanced axillary nodal disease in clinically node-positive breast cancer patients.
Article in Scientific reports, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 21 citations in OpenAlex.
- AlEuropean journal of nuclear medicine and molecular imaging · 2026Article
- Artificial Intelligence in Triple-Negative Breast Cancer: Applications in Diagnosis, Treatment Response, and Prognosis.Diagnostics (Basel, Switzerland) · 2026Review
- Sonographic localisation of lymph nodes suspicious of metastatic breast cancer to surgical axillary levels.Journal of medical radiation sciences · 2025Review
- [Insights into imaging · 2024Article
- Determination of axillary lymph node status by fine-needle aspiration: preoperative axillary stagingQuantitative imaging in medicine and surgery · 2024Article
- Predictive nomogram using multimodal ultrasonographic features for axillary lymph node metastasis in early‑stage invasive breast cancer.Oncology letters · 2024Article
- Early Warning of Axillary Lymph Node Metastasis in Breast Cancer Patients Using Multi-Omics Signature: A Machine Learning-Based Retrospective Study.International journal of general medicine · 2024Article
- Three-year follow-up of de-escalated axillary treatment after neoadjuvant systemic therapy in clinically node-positive breast cancer: the MARI-protocol.Breast cancer research and treatment · 2022Article
- Axillary ultrasound during neoadjuvant systemic therapy in triple-negative breast cancer patients.European journal of radiology · 2020Article
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10 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
Preoperative differentiation between limited (pN1; 1-3 axillary metastases) and advanced (pN2-3; ≥4 axillary metastases) nodal disease can provide relevant information regarding surgical planning and guiding adjuvant radiation therapy. The aim was to evaluate the diagnostic performance of preoperative axillary ultrasound (US) and breast MRI for differentiation between pN1 and pN2-3 in clinically node-positive breast cancer. A total of 49 patients were included with axillary metastasis confirmed by US-guided tissue sampling. All had undergone breast MRI between 2008-2014 and subsequent axillary lymph node dissection. Unenhanced T2-weighted MRI exams were reviewed by two radiologists independently. Each lymph node on the MRI exams was scored using a confidence scale (0-4) and compared with histopathology. Diagnostic performance parameters were calculated for differentiation between pN1 and pN2-3. Interobserver agreement was determined using Cohen's kappa coefficient. At final histopathology, 67.3% (33/49) and 32.7% (16/49) of patients were pN1 and pN2-3, respectively. Breast MRI was comparable to US in terms of accuracy (MRI reader 1 vs US, 71.4% vs 69.4%, p = 0.99; MRI reader 2 vs US, 73.5% vs 69.4%, p = 0.77). In the case of 1-3 suspicious lymph nodes, pN2-3 was observed in 30.4% on US (positive predictive value (PPV) 69.6%) and in 22.2-24.3% on MRI (PPV 75.7-77.8%). In the case of ≥4 suspicious lymph nodes, pN1 was observed in 33.3% on US (negative predictive value (NPV) 66.7%) and in 38.5-41.7% on MRI (NPV 58.3-61.5%). Interobserver agreement was considered good (k = 0.73). In clinically node-positive patients, the diagnostic performance of axillary US and breast MRI is comparable and limited for accurate differentiation between pN1 and pN2-3. Therefore, there seems no added clinical value of preoperative breast MRI regarding nodal staging in patients with positive axillary US.
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