American journal of surgery · 2000
The correlation of axillary ultrasonography with histologic breast cancer downstaging after induction chemotherapy.
Клиническое исследованиеСравнительное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Vlastos G, Fornage B D, Mirza N Q, Bedi D, Lenert J T, Winchester D J, Tolley S M, Ames F C, Ross M I, Feig B W, Hunt K K, Buzdar A U, Singletary S E
Аннотация
BACKGROUND: The goal of this study was to examine the role of ultrasonography in detecting axillary lymph node metastases in stage II breast cancer patients after induction chemotherapy (IC).
METHODS: Of 172 consecutive patients with T1-3, N0-1, M0 breast cancer registered in a prospective IC trial, a subset of 130 evaluable patients were chosen, with (1) both physical and ultrasonographic examinations of the axilla before and after IC; (2) exactly four cycles of IC; (3) no presurgical radiation therapy; and (4) an axillary lymph node dissection.
RESULTS: Before IC, 32 patients (25%) were negative for axillary involvement by both physical and ultrasonographic examinations. After IC, this number increased to 64 (49%). Of these, 31 (48%) were positive by pathology examination. In most cases, however, the residual tumor was minimal.
CONCLUSIONS: Stage II breast cancer patients who were or became node negative by both ultrasonographic and physical examinations after IC had a 48% incidence of nodal metastases. Because the residual tumor was minimal, irradiation may be sufficient for adequate local control of the axilla.
METHODS: Of 172 consecutive patients with T1-3, N0-1, M0 breast cancer registered in a prospective IC trial, a subset of 130 evaluable patients were chosen, with (1) both physical and ultrasonographic examinations of the axilla before and after IC; (2) exactly four cycles of IC; (3) no presurgical radiation therapy; and (4) an axillary lymph node dissection.
RESULTS: Before IC, 32 patients (25%) were negative for axillary involvement by both physical and ultrasonographic examinations. After IC, this number increased to 64 (49%). Of these, 31 (48%) were positive by pathology examination. In most cases, however, the residual tumor was minimal.
CONCLUSIONS: Stage II breast cancer patients who were or became node negative by both ultrasonographic and physical examinations after IC had a 48% incidence of nodal metastases. Because the residual tumor was minimal, irradiation may be sufficient for adequate local control of the axilla.
Предметные рубрики MeSH
AdultAgedAntineoplastic Combined Chemotherapy ProtocolsAxillaBiopsy, NeedleBreast NeoplasmsCombined Modality TherapyCyclophosphamideDexamethasoneDoxorubicinFemaleFluorouracilFollow-Up StudiesHumansLymph NodesLymphatic MetastasisMiddle AgedNeoplasm StagingPaclitaxelPhysical ExaminationPremedicationProspective StudiesRanitidineRemission InductionSensitivity and SpecificityUltrasonography