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Adding MRI to ultrasound and ultrasound-guided fine-needle aspiration reduces the false-negative rate of axillary lymph node metastasis diagnosis in breast cancer patients

 S.J. Hyun  ;  E.-K. Kim  ;  J.H. Yoon  ;  H.J. Moon  ;  M.J. Kim 
 CLINICAL RADIOLOGY, Vol.70(7) : 716-722, 2015 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Axilla ; Biopsy, Fine-Needle/methods ; Breast Neoplasms*/diagnostic imaging ; Breast Neoplasms*/pathology ; False Negative Reactions ; Female ; Humans ; Lymph Nodes*/diagnostic imaging ; Lymph Nodes*/pathology ; Lymphatic Metastasis*/diagnostic imaging ; Lymphatic Metastasis*/pathology ; Magnetic Resonance Imaging/methods* ; Middle Aged ; Neoplasm Staging ; Retrospective Studies ; Sensitivity and Specificity ; Sentinel Lymph Node Biopsy/methods* ; Ultrasonography, Interventional/methods* ; Young Adult
AIM: To evaluate whether adding magnetic resonance imaging (MRI) to ultrasound (US) and US-guided fine-needle aspiration (US-FNA) can reduce the false-negative rate (FNR) in the diagnosis of axillary lymph node metastasis (ALNM) in breast cancer patients, and to assess false-negative diagnosis of N2 and N3 disease when adding MRI to US and US-FNA. MATERIALS AND METHODS: From March 2012 to February 2013, 497 breast cancer patients were included in the study. ALNM was evaluated according to US and US-FNA prior to MRI. Second-look US was performed when MRI showed positive findings of ALNM. If second-look US also revealed a positive finding, US-FNA was performed. Diagnostic performance, including FNR, was calculated for US and US-FNA with and without MRI. The negative predictive value (NPV) of N2 and N3 disease was evaluated in negative cases based on US and US-FNA with MRI. RESULTS: A total of 159 of 497 (32.0%) patients were found to have ALNM. Among them, 92 patients were diagnosed with metastasis on US and US-FNA. When adding MRI to US and US-FNA, an additional six patients were diagnosed with metastasis. The FNR of diagnosis of ALNM was improved by the addition of MRI (42.1% versus 38.4%, p = 0.0143). The NPV for N2 and N3 disease was 98% (391/399) based on US and US-FNA with MRI. CONCLUSION: Adding MRI to US and US-FNA could reduce the FNR of the diagnosis of ALNM. Furthermore, US and US-FNA with MRI may exclude 98% of N2 and N3 disease.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Jung(김민정) ORCID logo https://orcid.org/0000-0003-4949-1237
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Moon, Hee Jung(문희정) ORCID logo https://orcid.org/0000-0002-5643-5885
Yoon, Jung Hyun(윤정현) ORCID logo https://orcid.org/0000-0002-2100-3513
Hyun, Su Jeong(현수정)
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