[Value of mamography, CT and DCE-MRI in detecting axillary lymph node metastasis of breast cancer].
OBJECTIVE
To evaluate the diagnostic value of mammography, computed tomography (CT), and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for axillary lymph node staging in breast cancer patients.


METHODS
From February, 2014 to October, 2015, 109 women with breast cancer received examinations with preoperative mamography, CT, and DCE-MRI. The diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the 3 modalities were evaluated using histopathologic assessments as the gold standard.


RESULTS
In total, 39.4% (43/109) of the patients had axillary lymph node metastasis. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of mamography for determining lymph node metastasis were 14.0%, 84.8%, 56.9%, 37.5% and 60.0%, respectively; those of CT were 93.0%, 57.6%, 71.6%,58.8% and 92.7%, and those of DCE-MRI were 95.3%, 65.2%, 77.1%, 64.1% and 95.6%, respectively. Compared with the histopathologic result, the Kappa coefficients of mamography, CT, and DCE-MRI were -0.13, 0.459 and 0.558, respectively. The specificity of mamography was significantly higher (P<0.05), but its sensitivity, accuracy, positive predictive value, and negative predictive value were significantly lower than those of CT and DCE-MRI (P<0.05). Compared with CT, DCE-MRI had significantly higher sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for diagnosis of lymph node metastasis (P<0.05).


CONCLUSIONS
DCE-MRI has a greater diagnostic power than CT and mammography, and CT has a greater diagnostic power than mammography for axillary lymph node metastasis in breast cancer patients. Mamography alone should be used cautiously for the diagnosis of lymph node metastasis.
1Southern Medical University, Guangzhou 510515, China; 2Guangdong General Hospital/Guangdong Academy of Medical Science, Guangzhou 510080, China. E-mail: peiqi_wu1992@163.com.
Pei-Qi
PQ
Wu
Chun-Ling
CL
Liu
Zai-Yi
ZY
Liu
Wei-Tao
WT
Ye
Chang-Hong
CH
Liang
D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008327:Mammography; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed