OBJECTIVE: The purpose of this study was to assess the prevalence of internal mammary node (IMN) adenopathy in patients with breast cancer and compare breast MRI and PET/CT for detection of IMN adenopathy. MATERIALS AND METHODS: This retrospective study included 90 women who underwent MRI and PET/CT before neoadjuvant chemotherapy for clinical stage IIA through IIIA disease. MRI and PET/CT examinations were read independently by two readers trained in breast imaging and nuclear medicine. All patients underwent follow-up MRI at the end of chemotherapy, and 10 with hypermetabolic IMNs underwent follow-up PET/CT. Histology was not obtained. Women were considered to have IMN adenopathy when nodes seen on MRI or having standardized uptake value (SUV) greater than mediastinal blood pool decreased in either size or SUV (or both) after treatment. Features including lymphovascular invasion, tumor quadrant(s), and axillary adenopathy were compared between presence and absence of IMN adenopathy using Fisher's exact test. Prevalence was determined on the basis of the percentage of patients with IMN adenopathy by either modality. The McNemar test compared the prevalence of IMN adenopathy on MRI to its prevalence on PET/CT. RESULTS: Prevalence of IMN adenopathy was 16% (14/90) by MRI and 14% (13/90) by PET/CT (p = 0.317). After chemotherapy, IMN adenopathy resolved in 12 of 14 patients (86%). In two patients with poor responses in primary tumors, IMN adenopathy persisted, and both patients developed metastatic disease within 6 months. At 3 years, survival was significantly worse in patients with IMN adenopathy than in those without (85.7% vs 53.3%, respectively; p = 0.009). CONCLUSION: In women with advanced breast cancer receiving neoadjuvant chemo-therapy, prevalence of IMN adenopathy was 16%, equally detected by breast MRI and PET/CT. Identification of IMN adenopathy may affect treatment and provides prognostic information.
OBJECTIVE: The purpose of this study was to assess the prevalence of internal mammary node (IMN) adenopathy in patients with breast cancer and compare breast MRI and PET/CT for detection of IMN adenopathy. MATERIALS AND METHODS: This retrospective study included 90 women who underwent MRI and PET/CT before neoadjuvant chemotherapy for clinical stage IIA through IIIA disease. MRI and PET/CT examinations were read independently by two readers trained in breast imaging and nuclear medicine. All patients underwent follow-up MRI at the end of chemotherapy, and 10 with hypermetabolic IMNs underwent follow-up PET/CT. Histology was not obtained. Women were considered to have IMN adenopathy when nodes seen on MRI or having standardized uptake value (SUV) greater than mediastinal blood pool decreased in either size or SUV (or both) after treatment. Features including lymphovascular invasion, tumor quadrant(s), and axillary adenopathy were compared between presence and absence of IMN adenopathy using Fisher's exact test. Prevalence was determined on the basis of the percentage of patients with IMN adenopathy by either modality. The McNemar test compared the prevalence of IMN adenopathy on MRI to its prevalence on PET/CT. RESULTS: Prevalence of IMN adenopathy was 16% (14/90) by MRI and 14% (13/90) by PET/CT (p = 0.317). After chemotherapy, IMN adenopathy resolved in 12 of 14 patients (86%). In two patients with poor responses in primary tumors, IMN adenopathy persisted, and both patients developed metastatic disease within 6 months. At 3 years, survival was significantly worse in patients with IMN adenopathy than in those without (85.7% vs 53.3%, respectively; p = 0.009). CONCLUSION: In women with advanced breast cancer receiving neoadjuvant chemo-therapy, prevalence of IMN adenopathy was 16%, equally detected by breast MRI and PET/CT. Identification of IMN adenopathy may affect treatment and provides prognostic information.
Entities:
Keywords:
PET/CT; breast MRI; breast cancer; internal mammary nodes; neoadjuvant chemotherapy
Authors: U Veronesi; N Cascinelli; M Greco; R Bufalino; A Morabito; D Galluzzo; R Conti; R De Lellis; V Delle Donne; P Piotti Journal: Ann Surg Date: 1985-12 Impact factor: 12.969
Authors: Tjeerd S Aukema; Marieke E Straver; Marie-Jeanne T F D Vrancken Peeters; Nicola S Russell; Kenneth G A Gilhuijs; Wouter V Vogel; Emiel J T Rutgers; Renato A Valdés Olmos Journal: Eur J Cancer Date: 2010-08-16 Impact factor: 9.162
Authors: Yu-Jing Zhang; Julia L Oh; Gary J Whitman; Puneeth Iyengar; Tse-Kuan Yu; Welela Tereffe; Wendy A Woodward; George Perkins; Thomas A Buchholz; Eric A Strom Journal: Int J Radiat Oncol Biol Phys Date: 2009-12-11 Impact factor: 7.038
Authors: David N Danforth; Luigi Aloj; Jorge A Carrasquillo; Stephen L Bacharach; Cathy Chow; JoAnne Zujewski; Millie Whatley; Barbara Galen; Maria Merino; Ronald D Neumann Journal: Breast Cancer Res Treat Date: 2002-09 Impact factor: 4.872
Authors: Carolyn L Wang; Marna J Eissa; James V Rogers; Aleksandr Y Aravkin; Bruce A Porter; J David Beatty Journal: AJR Am J Roentgenol Date: 2013-05 Impact factor: 3.959
Authors: Jennifer R Bellon; Robert B Livingston; William B Eubank; Julie R Gralow; Georgiana K Ellis; Lisa K Dunnwald; David A Mankoff Journal: Am J Clin Oncol Date: 2004-08 Impact factor: 2.339
Authors: U Veronesi; P Arnone; P Veronesi; V Galimberti; A Luini; N Rotmensz; E Botteri; G B Ivaldi; M C Leonardi; G Viale; A Sagona; G Paganelli; R Panzeri; R Orecchia Journal: Ann Oncol Date: 2008-05-07 Impact factor: 32.976
Authors: V Habraken; T J A van Nijnatten; L de Munck; M Moossdorff; E M Heuts; M B I Lobbes; M L Smidt Journal: Breast Cancer Res Treat Date: 2016-12-03 Impact factor: 4.872
Authors: Amy J Xu; Carl J DeSelm; Alice Y Ho; Erin F Gillespie; Lior Z Braunstein; Atif J Khan; Beryl McCormick; Simon N Powell; Oren Cahlon Journal: Adv Radiat Oncol Date: 2019-03-01