The correlation of axillary ultrasonography with histologic breast cancer downstaging after induction chemotherapy.
BACKGROUND
The goal of this study was to examine the role of ultrasonography in detecting axillary lymph node metastases in stage II breast cancer patients after induction chemotherapy (IC).


METHODS
Of 172 consecutive patients with T1-3, N0-1, M0 breast cancer registered in a prospective IC trial, a subset of 130 evaluable patients were chosen, with (1) both physical and ultrasonographic examinations of the axilla before and after IC; (2) exactly four cycles of IC; (3) no presurgical radiation therapy; and (4) an axillary lymph node dissection.


RESULTS
Before IC, 32 patients (25%) were negative for axillary involvement by both physical and ultrasonographic examinations. After IC, this number increased to 64 (49%). Of these, 31 (48%) were positive by pathology examination. In most cases, however, the residual tumor was minimal.


CONCLUSIONS
Stage II breast cancer patients who were or became node negative by both ultrasonographic and physical examinations after IC had a 48% incidence of nodal metastases. Because the residual tumor was minimal, irradiation may be sufficient for adequate local control of the axilla.
Vlastos
G
G
Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA.
Fornage
B D
BD
Mirza
N Q
NQ
Bedi
D
D
Lenert
J T
JT
Winchester
D J
DJ
Tolley
S M
SM
Ames
F C
FC
Ross
M I
MI
Feig
B W
BW
Hunt
K K
KK
Buzdar
A U
AU
Singletary
S E
SE
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001365:Axilla; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage; D010808:Physical Examination; D011292:Premedication; D011446:Prospective Studies; D011899:Ranitidine / Q000008:administration & dosage; D012074:Remission Induction; D012680:Sensitivity and Specificity; D014463:Ultrasonography
D003907:Dexamethasone; D004317:Doxorubicin; D011899:Ranitidine; D003520:Cyclophosphamide; D017239:Paclitaxel; D005472:Fluorouracil