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Clinical and Translational Oncology

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01-04-2020 | Ultrasound | Research Article

Evaluation of axillary lymph node metastasis burden by preoperative ultrasound in early-stage breast cancer with needle biopsy-proven metastasis

Authors: X. Wang, L. Chen, Y. Sun, B. Zhang

Published in: Clinical and Translational Oncology | Issue 4/2020

Abstract

Purpose

The findings from the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial have questioned the use of axillary lymph node (ALN) dissection (ALND) in breast cancer patients with low ALN burden. In this study, our aim was to evaluate axillary nodal metastasis burden in patients with early-stage breast cancer who presented with metastatic lymph nodes diagnosed by fine needle aspiration biopsy (FNAB).

Methods

The data from 346 patients with cT1–T2 breast cancer who showed positive FNAB results and were seen at Tianjin Medical University Cancer Hospital from January 2014 to December 2017 were retrospectively analyzed. The patients were divided into high axillary nodal burden (≥ 3 positive lymph nodes) or low axillary nodal burden (one to two positive lymph nodes) groups. The clinical, radiological, and pathological features were compared between the two groups.

Results

From the 346 patients, 136 (39.3%) had low axillary nodal burden and 210 patients had high axillary nodal burden. Compared to patients with high metastatic burden, the patients with low metastatic burden were more likely to have two or fewer abnormal lymph nodes detected by AUS (95.6% vs. 65.3%, p < 0.05), and more likely to have HR⁻/HER2⁻ lesions (15.4% vs. 5.2%, p < 0.05). Multivariate analysis revealed that patients with more than two abnormal lymph nodes had an odds ratio of 18.385 (95% CI 7.315–46.205, p < 0.05) to have axillary metastasis.

Conclusions

The presence of three or more abnormal lymph nodes on AUS was a significant indicator of high axillary nodal burden in early-stage breast cancer patients with positive FNAB findings. The combination of radiological and clinicopathological findings allows physicians to identify patients with high axillary nodal burden who will likely benefit from ALND in the post-ACOSOG Z0011 trial era.

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Title: Evaluation of axillary lymph node metastasis burden by preoperative ultrasound in early-stage breast cancer with needle biopsy-proven metastasis
Authors: X. Wang
L. Chen
Y. Sun
B. Zhang
Publication date: 01-04-2020
Publisher: Springer International Publishing
Keywords: Ultrasound
Metastasis
Breast Cancer
Breast Cancer
Ultrasound
Published in: Clinical and Translational Oncology / Issue 4/2020
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI: https://doi.org/10.1007/s12094-019-02162-3

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Abstract

Purpose

Methods

Results

Conclusions

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