Preoperative axillary lymph node evaluation in breast cancer patients by breast magnetic resonance imaging (MRI): Can breast MRI exclude advanced nodal disease?
Preoperative axillary lymph node evaluation in breast cancer patients by breast magnetic resonance imaging (MRI): Can breast MRI exclude advanced nodal disease?
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DOI：
10.1007/s00330-016-4235-4
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发表时间：
2016-11-01
影响因子：
5.9
通讯作者：
Kim, Min Jung
中科院分区：
文献类型：
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作者：
Hyun, Su Jeong;Kim, Eun-Kyung;Kim, Min Jung
为评价乳腺磁共振成像(MRI)对乳腺癌腋窝淋巴结转移(ALNM)的诊断价值，探讨乳腺MRI在排除晚期淋巴结转移中的作用。对所有患者、接受新辅助化疗(NAC)的患者和未接受新辅助化疗的患者(NO-NAC)的乳腺MRI诊断ALNM的能力进行评估。用阴性预测值(NPV)评价MRI阴性结果(CN0)能否排除晚期结节病变(pn2-pN3)，乳腺MRI诊断ALNM的敏感性和NPV分别为51.3%(60/117)和83.3%(284/341)。341例cN0患者中，pN2-pN3出现率为1.8%(6/341)，无NAC组为0.4%(1/257)，NAC组为6%(5/84)。排除pN2-pN3的MRI阴性发现的NPV在无NAC组高于NAC组(99.6%比94.0%，在无NAC组中，阴性的mri结果(CN0)可以排除晚期结节病变的存在，其净现值为99.6%。a欧洲中心乳房MRI可用于排除晚期结节疾病(pn2-3)。a欧洲中心阴性mri使乳腺癌患者避免不必要的腋窝手术(98.2%)。a欧洲中心阴性mri结果排除了无nac组99.6%的pn2-pN3。欧洲阴性mri结果排除了NAC组96.0%的pn2-pN3。
To evaluate the diagnostic performance of breast magnetic resonance imaging (MRI) in preoperative evaluation of axillary lymph node metastasis (ALNM) in breast cancer patients and to assess whether breast MRI can be used to exclude advanced nodal disease.A total of 425 patients were included in this study and breast MRI findings were retrospectively reviewed. The diagnostic performance of breast MRI for diagnosis of ALNM was evaluated in all patients, patients with neoadjuvant chemotherapy (NAC), and those without NAC (no-NAC). We evaluated whether negative MRI findings (cN0) can exclude advanced nodal disease (pN2-pN3) using the negative predictive value (NPV) in each group.The sensitivity and NPV of breast MRI in evaluation of ALNM was 51.3 % (60/117) and 83.3 % (284/341), respectively. For cN0 cases on MRI, pN2-pN3 manifested in 1.8 % (6/341) of the overall patients, 0.4 % (1/257) of the no-NAC group, and 6 % (5/84) of the NAC group. The NPV of negative MRI findings for exclusion of pN2-pN3 was higher for the no-NAC group than for the NAC group (99.6 % vs. 94.0 %, p = 0.039).Negative MRI findings (cN0) can exclude the presence of advanced nodal disease with an NPV of 99.6 % in the no-NAC group.aEuro cent Breast MRI can be used to exclude advanced nodal disease (pN2-3).aEuro cent Negative MRI allows breast cancer patients to avoid unnecessary axillary surgery (98.2 %).aEuro cent Negative MRI findings exclude 99.6 % of pN2-pN3 in the no-NAC group.aEuro cent Negative MRI findings exclude 96.0 % of pN2-pN3 in the NAC group.