Ruth Helfgott1, Martina Mittlböck2, Maria Miesbauer3, Farid Moinfar4, Silke Haim5, Maria Mascherbauer6, Paul Schlagnitweit6, Dietmar Heck6, Michael Knauer7, Florian Fitzal8. 1. Sisters of Charity, Breast Health Center and Department of Surgery, Linz, Austria. Electronic address: ruth.helfgott@ordensklinikum.at. 2. Medical University Vienna and Cancer Comprehensive Center, Department of Bioinformatic and Statistic, Austria. 3. Department of Radiology, Linz, Austria. 4. Department of Pathology, Linz, Austria. 5. Department of Nuclear Medicine, Linz, Austria. 6. Sisters of Charity, Breast Health Center and Department of Surgery, Linz, Austria. 7. St Gallen Breast Health Center, Austria. 8. Medical University Vienna and Cancer Comprehensive Center, Department of Surgery, Austria.
Abstract
INTRODUCTION: Axillary ultrasound staging (AUS) is an important tool to guide clinical decisions in breast cancer therapy, especially regarding axillary surgery but also radiation therapy. It is unknown whether biological subtypes influence axillary staging using ultrasound (AUS). METHOD: This is a retrospective single center analysis. All patients with breast cancer, a preoperative axillary ultrasound and a complete surgical axillary staging were included between 1999 and 2014, except patients with neoadjuvant chemotherapy (NACT). The results of the AUS were compared with final pathological results. Biological subtypes were identified by immunohistochemistry. RESULTS: 583 women were included in the study. Sensitivity, Specificity, positive and negative predictive value for AUS were 39%, 96%, 91% and 83%. While sensitivity was significantly lower in Luminal A and B patients (25.0%; 39.8%) as compared to non Luminal breast cancer patients (TN 68.8%; Her2+ 71.4%; p = 0.0032), there were no significant differences between the groups with respect to specificity, PPV and NPV. CONCLUSION: Solely regarding sensitivity of AUS, our study could show significant differences between biological subtypes of breast cancer with lower sensitivity in Luminal patients. While PPV was excellent, standing for a low overtreatment rate using AUS for clinical decision making, sensitivity was poor overall, comparable to the results of other studies.
INTRODUCTION: Axillary ultrasound staging (AUS) is an important tool to guide clinical decisions in breast cancer therapy, especially regarding axillary surgery but also radiation therapy. It is unknown whether biological subtypes influence axillary staging using ultrasound (AUS). METHOD: This is a retrospective single center analysis. All patients with breast cancer, a preoperative axillary ultrasound and a complete surgical axillary staging were included between 1999 and 2014, except patients with neoadjuvant chemotherapy (NACT). The results of the AUS were compared with final pathological results. Biological subtypes were identified by immunohistochemistry. RESULTS: 583 women were included in the study. Sensitivity, Specificity, positive and negative predictive value for AUS were 39%, 96%, 91% and 83%. While sensitivity was significantly lower in Luminal A and B patients (25.0%; 39.8%) as compared to non Luminal breast cancerpatients (TN 68.8%; Her2+ 71.4%; p = 0.0032), there were no significant differences between the groups with respect to specificity, PPV and NPV. CONCLUSION: Solely regarding sensitivity of AUS, our study could show significant differences between biological subtypes of breast cancer with lower sensitivity in Luminal patients. While PPV was excellent, standing for a low overtreatment rate using AUS for clinical decision making, sensitivity was poor overall, comparable to the results of other studies.
Authors: Covadonga Martí; Laura Yébenes; José María Oliver; Elisa Moreno; Laura Frías; Alberto Berjón; Adolfo Loayza; Marcos Meléndez; María José Roca; Vicenta Córdoba; David Hardisson; María Ángeles Rodríguez; José Ignacio Sánchez-Méndez Journal: Curr Oncol Date: 2022-03-23 Impact factor: 3.109