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Breast Cancer
Published in: Breast Cancer 5/2019

01-09-2019 | Magnetic Resonance Imaging | Original Article

Predicting metastasis in clinically negative axillary lymph nodes with minimum apparent diffusion coefficient value in luminal A-like breast cancer

Authors: Fumi Kato, Kohsuke Kudo, Hiroko Yamashita, Motoi Baba, Ai Shimizu, Noriko Oyama-Manabe, Rumiko Kinoshita, Ruijiang Li, Hiroki Shirato

Published in: Breast Cancer | Issue 5/2019

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Abstract

Background

We investigated the usefulness of the minimum ADC value of primary breast lesions for predicting axillary lymph node (LN) status in luminal A-like breast cancers with clinically negative nodes in comparison with the mean ADC.

Methods

Forty-four luminal A-like breast cancers without axillary LN metastasis at preoperative clinical evaluation, surgically resected with sentinel LN biopsy, were retrospectively studied. Mean and minimum ADC values of each lesion were measured and statistically compared between LN positive (n = 12) and LN negative (n = 32) groups. An ROC curve was drawn to determine the best cutoff value to differentiate LN status. Correlations between mean and minimum ADC values and the number of metastatic axillary LNs were investigated.

Results

Mean and minimum ADC values of breast lesions with positive LN were significantly lower than those with negative LN (mean 839.9 ± 110.9 vs. 1022.2 ± 250.0 × 10− 6 mm2/s, p = 0.027, minimum 696.7 ± 128.0 vs. 925.0 ± 257.6 × 10− 6 mm2/s, p = 0.004). The sensitivity and NPV using the best cutoff value from ROC using both mean and minimum ADC were 100%. AUC of the minimum ADC (0.784) was higher than that of the mean ADC (0.719). Statistically significant negative correlations were observed between both mean and minimum ADCs and number of positive LNs, with stronger correlation to minimum ADC than mean ADC.

Conclusions

The minimum ADC value of primary breast lesions predicts axillary LN metastasis in luminal A-like breast cancer with clinically negative nodes, with high sensitivity and high NPV.
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Metadata
Title
Predicting metastasis in clinically negative axillary lymph nodes with minimum apparent diffusion coefficient value in luminal A-like breast cancer
Authors
Fumi Kato
Kohsuke Kudo
Hiroko Yamashita
Motoi Baba
Ai Shimizu
Noriko Oyama-Manabe
Rumiko Kinoshita
Ruijiang Li
Hiroki Shirato
Publication date
01-09-2019
Publisher
Springer Japan
Published in
Breast Cancer / Issue 5/2019
Print ISSN: 1340-6868
Electronic ISSN: 1880-4233
DOI
https://doi.org/10.1007/s12282-019-00969-0

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