The diagnostic contribution of magnetic resonance imaging in the detection of axillary metastasis after neoadjuvant chemotherapy

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dc.authoridCavdar, Eyyup/0000-0001-5885-3047
dc.authorscopusid57226431644
dc.authorscopusid57431169800
dc.authorscopusid57226624079
dc.authorscopusid56082620300
dc.authorscopusid56085483700
dc.authorscopusid15844109600
dc.authorscopusid8204207500
dc.contributor.authorİriağaç, Yakup
dc.contributor.authorKaraboyun, Kubilay
dc.contributor.authorÇavdar, Eyyüp
dc.contributor.authorAvcı, Okan
dc.contributor.authorKurtoğlu Özçağlayan, Tuğba İlkem
dc.contributor.authorÖznur, Meltem
dc.contributor.authorŞeber, Erdoğan Selçuk
dc.date.accessioned2023-04-20T08:01:15Z
dc.date.available2023-04-20T08:01:15Z
dc.date.issued2022
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
dc.departmentFakülteler, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Tıbbi Patoloji Ana Bilim Dalı
dc.description.abstractSentinel lymph node dissection (SLND) is a reliable method that provides axillary staging in clinical node-negative (cN0) breast cancer patients before neoadjuvant chemotherapy (NACT). However, it is not a standard method on its own due to the high false-negative rates (FNR) reported in initially clinical node-positive patients (cN1-cN3). The contribution of magnetic resonance imaging (MRI) to SLND after chemotherapy is not well understood. In our study, we aimed to investigate the contribution of post-NACT MRI to SLND in breast cancer patients receiving NACT. Between January 2014 and December 2020, patients who had MRI images including the axilla after NACT and had axillary lymph nodes evaluation performed simultaneously with SLND were included in the study. MRI images of all patients were re-evaluated by 2 experienced clinicians. MRI and SLND results were analyzed to detect axillary lymph node metastasis. 117 patients were included in the study. The median age of the patients was 49 years. Before chemotherapy, 108 patients (92.3%) had tumor metastases in their axilla pathologically confirmed by tru-cut biopsy. Axillary downstage was obtained in 48.1% (n=52) of the patients after NACT. Of the 56 patients with axillary node positivity, 3 patients had no metastasis in the SLND evaluation (FNR=5.4%). The sensitivity of post-NACT MRI in detecting node positivity was 69.6%, the specificity was 90.2%, the positive predictive value (PPV) was 86.7% and the negative predictive value (NPV) was 76.4. SLND together with MRI predicted all node-positive patients (FNR=0%). In summary, SLND may not detect a group of patients with residual axillary lymph node metastases after NACT. We have shown that MRI can contribute to identifying these patients. If no metastases are detected by both methods (SLND and MRI), avoidance of axillary dissection may be an acceptable choice.
dc.identifier.doi10.4149/neo_2022_220127N122
dc.identifier.endpage746
dc.identifier.issn0028-2685
dc.identifier.issn1338-4317
dc.identifier.issue3en_US
dc.identifier.pmid35471979
dc.identifier.scopus2-s2.0-85131770708
dc.identifier.scopusqualityQ2
dc.identifier.startpage741
dc.identifier.urihttps://doi.org/10.4149/neo_2022_220127N122
dc.identifier.urihttps://hdl.handle.net/20.500.11776/10822
dc.identifier.volume69
dc.identifier.wosWOS:000818004200007
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorİriağaç, Yakup
dc.institutionauthorKaraboyun, Kubilay
dc.institutionauthorÇavdar, Eyyup
dc.institutionauthorAvcı, Okan
dc.institutionauthorSeber, Erdogan Selcuk
dc.institutionauthorKurtoğlu Özçağlayan, Tuğba İlkem
dc.institutionauthorÖznur, Meltem
dc.institutionauthorGürdal, Sibel Özkan
dc.language.isoen
dc.publisherAepress Sro
dc.relation.ispartofNeoplasma
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectBreast Cancer
dc.subjectNeoadjuvant Chemotherapy
dc.subjectSentinel Lymph Node Dissection
dc.subjectMri
dc.subjectAlnd
dc.subjectPositive Breast-Cancer
dc.subjectSentinel Node Biopsy
dc.subjectQuality-Of-Life
dc.subjectLymph-Nodes
dc.subjectProtocol
dc.subjectTrial
dc.subjectMri
dc.subjectDissection
dc.subjectPrediction
dc.subjectManagement
dc.titleThe diagnostic contribution of magnetic resonance imaging in the detection of axillary metastasis after neoadjuvant chemotherapy
dc.typeArticle

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