Axillary ultrasound examination is useful for selecting patients optimally suited for sentinel lymph node biopsy after primary systemic chemotherapy

作者：Shigekawa Takashi; Sugitani Ikuko; Takeuchi Hideki; Misumi Misono; Nakamiya Noriko; Sugiyama Michiko; Sano Hiroshi; Matsuura Kazuo; Takahashi Takao; Fujiuchi Nobuko; Osaki Akihiko; Saeki Toshiaki^*

来源：American Journal of Surgery, 2012, 204(4): 487-493.

DOI：10.1016/j.amjsurg.2011.09.026

• Breast cancer
• Axillary ultrasound examination
• Primary systemic chemotherapy
• Sentinel lymph node biopsy
• False-negative rate

BACKGROUND: Controversy surrounds the reliability of sentinel lymph node biopsy after primary systemic chemotherapy. In this study, we assessed axillary ultrasound for selecting patients most likely to optimally benefit from biopsy. %26lt;br%26gt;METHODS: The study included 87 patients who received primary systemic chemotherapy and underwent a sentinel lymph node biopsy followed by axillary lymph node dissection. Lymph nodes %26gt;10 mm in diameter, irregularly swollen, round, and homogeneously hypoechoic without an echo-rich center were considered axillary ultrasound positive. %26lt;br%26gt;RESULTS: In axillary ultrasound-negative patients before and after primary systemic chemotherapy, identification, sensitivity, and false-negative rates were 81%, 100%, and 0%, respectively. However, in patients whose lymph nodes converted from positive to negative after primary systemic chemotherapy, these values were 83%, 70.8%, and 29.2%, respectively. %26lt;br%26gt;CONCLUSIONS: Axillary ultrasound-negative patients before and after primary systemic chemotherapy were suitable for sentinel lymph node biopsy. Axillary ultrasound should be used during primary systemic chemotherapy and before surgery.

• 出版日期2012-10