Translate this page into:
Ultrasound and Elastographic Features predicting Axillary Nodal Metastasis in Breast Cancer
Corresponding Author: Suresh V Phatak, Professor and Head, Department of Radiodiagnosis, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India, Phone: +917152287701, e-mail: suresh_phatak@yahoo.com
This article was originally published by Thieme Medical and Scientific Publishers Private Ltd. and was migrated to Scientific Scholar after the change of Publisher.
How to cite this article: Phatak SV, Shinde RK, Gupta NA, Pawar G, Phatak PS. Ultrasound and Elastographic Features predicting Axillary Nodal Metastasis in Breast Cancer. Int J Recent Surg Med Sci 2017;3(2):127-129.
Abstract
Lymph node metastasis is an important prognostic factor in cases of carcinoma breast. In this pictorial essay, various sonographic and elastographic signs of lymph node metastasis are described with classical images.
Keywords
Axilla
Breast
Elastography
Metastasis
Ultrasound
INTRODUCTION
Axillary lymph node metastasis is an important prognostic factor in early-stage breast cancer and remains crucial on which individual treatment decisions are made.1 Mammography has its limitations in detecting metastatic lymph nodes because the entire axillary region cannot be adequately evaluated with this method. Positron emission tomography combined with computed tomography and magnetic resonance imaging do not have a place in routine staging because of higher costs and possibility of side effects.2 Ultrasonography (USG) is the most widely used imaging method for detection of axillary lymph node metastasis and for their characterization.3
Ultrasonography Appearance of Normal Axillary Lymph Node (Fig. 1)
Ultrasonography Features of Malignant Axillary Lymph Node
Cortical Thickening (Fig. 2)
Marked Hypoechogenicity and Loss of Fatty Hilum (Fig. 3)
Calcification (Fig. 4)
Capsular Breach (Fig. 5)
Longitudinal–transverse Axis Ratio (Fig. 6)
Cortex to Hilum Ratio (Figs 7 and 8)
Sonoelastographic Findings in Metastatic Lymph Node (Figs 9 and 10)
Elastography Scoring System for Metastatic Lymph Node (Fig. 11)4-9
SUMMARY
Metastasis to axillary lymph node is an important factor in the prognosis of early-stage breast cancer and crucial for decision-making in management. There are many classical gray-scale and elastographic features that predict metastasis to axillary lymph node. These features are discussed in brief and classical images are illustrated in patients of breast cancer. These features help in early detection of lymph node metastasis.
Source of support:
Nil
Conflict of interest:
None.
REFERENCES
- Assessment of ultrasound features predicting axillary nodal metastasis in breast cancer: the impact of cortical thickness. Ultrasound Int Open. 2015;1(1):E19-E24.
- [CrossRef] [PubMed] [Google Scholar]
- The use of FDG-PET in assessing axillary lymph node status in breast cancer: a systematic review and meta-analysis of literature. Breast Cancer Res Treat. 2010;123(1):281-290.
- [CrossRef] [PubMed] [Google Scholar]
- Preoperative ultrasound-guided needle biopsy of axillary nodes in invasive breast cancer: meta-analysis of its accuracy and utility in staging the axilla. Ann Surg. 2011;254(2):243-251.
- [CrossRef] [PubMed] [Google Scholar]
- Local and regional staging of invasive breast cancer with sonography: 25 years of Practice at MD Anderson Cancer Center. Oncologist. 2014;19(1):5-15.
- [CrossRef] [PubMed] [Google Scholar]
- Metastatic breast carcinoma in axillary lymph nodes: in vitro US detection. Radiology. 1997;205(3):831-835.
- [CrossRef] [PubMed] [Google Scholar]
- Classification of metastatic versus non-metastatic axillary nodes in breast cancer patients: value of cortex-hilum area ratio with ultrasound. J Breast Cancer. 2012;15(1):65-70.
- [CrossRef] [PubMed] [Google Scholar]
- Real-time ultrasound elastography in 180 axillary lymph nodes: elasticity distribution in healthy lymph nodes and prediction of breast cancer metastases. BMC Med Imaging. 2012;12:35.
- [CrossRef] [PubMed] [Google Scholar]
- Role of sonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer. J Ultrasound Med. 2011;30(4):429-436.
- [CrossRef] [PubMed] [Google Scholar]