Role of Ultrasonography of Regional Nodal Basins in Staging Triple-Negative Breast Cancer and Implications For Local-Regional Treatment

Journal Article · Tue Sep 01 00:00:00 EDT 2015 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2015.05.015· OSTI ID:22458753

Tereffe, Welela ^[1]; Dogan, Basak E. ^[2]; Hess, Kenneth R. ^[3]; Caudle, Abigail S. ^[4]; Valero, Vicente ^[5]; Stauder, Michael C. ^[1]; Krishnamurthy, Savitri ^[6]; Candelaria, Rosalind P. ^[2]; Strom, Eric A.; Woodward, Wendy A. ^[1]; Hunt, Kelly K. ^[4]; Buchholz, Thomas A. ^[1]; Whitman, Gary J. ^[2]

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1. Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
2. Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
3. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
4. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
5. Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
6. Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

Purpose: We sought to determine the rate at which regional nodal ultrasonography would increase the nodal disease stage in patients with triple-negative breast cancer (TNBC) beyond the clinical stage determined by physical examination and mammography alone, and significantly affect the treatments delivered to these patients. Methods and Materials: We retrospectively reviewed the charts of women with stages I to III TNBC who underwent physical examination, mammography, breast and regional nodal ultrasonography with needle biopsy of abnormal nodes, and definitive local-regional treatment at our institution between 2004 and 2011. The stages of these patients' disease with and without ultrasonography of the regional nodal basins were compared using the Pearson χ{sup 2} test. Definitive treatments of patients whose nodal disease was upstaged on the basis of ultrasonographic findings were compared to those of patients whose disease stage remained the same. Results: A total of 572 women met the study requirements. In 111 (19.4%) of these patients, regional nodal ultrasonography with needle biopsy resulted in an increase in disease stage from the original stage by physical examination and mammography alone. Significantly higher percentages of patients whose nodal disease was upstaged by ultrasonographic findings compared to that in patients whose disease was not upstaged underwent neoadjuvant systemic therapy (91.9% and 51.2%, respectively; P<.0001), axillary lymph node dissection (99.1% and 34.5%, respectively; P<.0001), and radiation to the regional nodal basins (88.2% and 29.1%, respectively; P<.0001). Conclusions: Regional nodal ultrasonography in TNBC frequently changes the initial clinical stage and plays an important role in treatment planning.

• OSTI ID: 22458753
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 93, Issue 1; Other Information: Copyright (c) 2015 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BIOMEDICAL RADIOGRAPHY
BIOPSY
COMPARATIVE EVALUATIONS
LYMPH NODES
MAMMARY GLANDS
NEOPLASMS
PATIENTS
PLANNING
REVIEWS
THERAPY
ULTRASONOGRAPHY
WOMEN