title: Diagnostic strategy for the assessment of axillary lymph node status in breast cancer.
abstract: The nodal status in breast cancer is a major prognostic factor in terms of survival. It also plays a role in the therapeutic decision-making process. Therefore, the evaluation of lymph node involvement in breast cancer is imperative in establishing a personalized treatment scheme. The sentinel lymph node procedure has proved successful for small breast tumors (T1-T2), limiting axillary lymphadenectomy and its side effects without changing overall survival. Even so, a substantial number of women must undergo axillary lymphadenectomy during a second surgery when the analysis of the sentinel node discloses major nodal involvement. Imaging can improve patient selection, especially those who appear eligible for immediate axillary lymphadenectomy. Ultrasound is able to depict morphological abnormalities in the lymph nodes such as cortical thickening, peripheral vascularization, hilar infiltration and loss of the kidney-shaped appearance of a normal node. When ultrasound is negative, the risk of massive nodal involvement is limited, thus allowing the oncologist to take an approach with the sentinel lymph node procedure. Magnetic resonance imaging (MRI) can also be useful in detecting pathological lymph nodes, particularly with diffusion-weighted MRI sequence.
authors.affiliation: Service de radiologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
authors.forename: F
authors.initials: F
authors.lastname: Maxwell
authors.affiliation: Service de radiologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
authors.forename: C
authors.initials: C
authors.lastname: de Margerie Mellon
authors.affiliation: Service de radiologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
authors.forename: M
authors.initials: M
authors.lastname: Bricout
authors.affiliation: Service de radiologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
authors.forename: E
authors.initials: E
authors.lastname: Cauderlier
authors.affiliation: Service de radiologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
authors.forename: M
authors.initials: M
authors.lastname: Chapelier
authors.affiliation: Service de radiologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
authors.forename: M
authors.initials: M
authors.lastname: Albiter
authors.affiliation: Service de radiologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
authors.forename: P
authors.initials: P
authors.lastname: Bourrier
authors.affiliation: Centre des maladies du sein, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
authors.forename: M
authors.initials: M
authors.lastname: Espié
authors.affiliation: Service de radiologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
authors.forename: E
authors.initials: E
authors.lastname: de Kerviler
authors.affiliation: Service de radiologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France. Electronic address: cedric.de-bazelaire@sls.aphp.fr.
authors.forename: C
authors.initials: C
authors.lastname: de Bazelaire
mesh_terms: D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D003663:Decision Trees; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D021701:Sentinel Lymph Node Biopsy
keywords: Axillary lymphadenopathy; Breast cancer; MRI; Staging; Ultrasound