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Usefulness of preoperative breast magnetic resonance imaging with a dedicated axillary sequence for the detection of axillary lymph node metastasis in patients with early ductal breast cancer

  • BREAST RADIOLOGY
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Objective

Axillary staging of primary breast cancer is important; however, axillary staging using advanced magnetic resonance imaging (MRI) techniques is very difficult to use. Therefore, we want to evaluate the diagnostic performance of preoperative MRI with a dedicated axillary sequence for axillary lymph node (ALN) metastasis in patients with early ductal breast cancer and determine potential predictors of axillary nodal positivity.

Materials and methods

We retrospectively reviewed the MRI findings for 74 consecutive patients diagnosed with invasive breast cancer. The diagnostic performances of axial images alone and axial + reconstructed coronal images for the detection of ALN metastasis were evaluated. The clinicopathological and MRI features of the primary breast cancer lesions were determined.

Results

The sensitivity (52.9% vs. 47.1%), specificity (89.5% vs. 71.9%), positive predictive value (60% vs. 33.3%), and negative predictive value (86.4% vs. 82%) for the preoperative detection of ALN metastasis were higher for axial + coronal images than for axial images. In addition, the area under the receiver operating characteristic curve value was higher for axial + coronal images than for axial images (0.595 vs. 0.712, p = 0.043). Peritumoral high signal intensity on T2-weighted images (p = 0.015) of the primary tumor was significantly associated with ALN metastasis.

Conclusion

Our findings suggest that preoperative axial + reconstructed coronal MR images exhibit good diagnostic performance for ALN metastasis in patients with early ductal breast cancer. In addition, peritumoral high signal intensity on T2-weighted images of the primary tumor can be used as a predictor of ALN metastasis in these patients.

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Funding

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (No. 2017R1D1A1B03033975).

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Authors and Affiliations

  1. Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102 Heukseok-Ro, Dongjak-Gu, Seoul, 06973, Republic of Korea

    Hye Shin Ahn

  2. Department of Radiology, Seoul National University Bundang Hospital, Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea

    Mijung Jang, Sun Mi Kim & Bo La Yun

  3. Department of Radiology, Chungbuk National University Hospital, 776 1Sunhwan-ro, Seowon-gu, Cheongju, Cungcheongbuk, 28644, Republic of Korea

    Soo Hyun Lee

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  1. Hye Shin Ahn
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Correspondence to Mijung Jang.

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Ahn, H.S., Jang, M., Kim, S.M. et al. Usefulness of preoperative breast magnetic resonance imaging with a dedicated axillary sequence for the detection of axillary lymph node metastasis in patients with early ductal breast cancer. Radiol med 124, 1220–1228 (2019). https://doi.org/10.1007/s11547-019-01072-2

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  • DOI: https://doi.org/10.1007/s11547-019-01072-2

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