The Role of US in Depicting Axillary Metastasis in High-Risk Breast Cancer Patients.
J Pers Med
; 11(12)2021 Dec 16.
Article
en En
| MEDLINE
| ID: mdl-34945851
ABSTRACT
PURPOSE:
The aim of this study is to evaluate the role of US in depicting axillary nodal disease in high-risk patients with and without pathogenic mutations.Methods:
The retrospective study included consecutive high-risk breast cancer (BC) patients who underwent a multigene testing panel for hereditary cancers, pre-operative axillary US and breast/axillary surgery. The group was divided into patients with pathogenic mutations (PM group) and patients without PM. Statistical analyses were performed using GraphPad Prism by applying Chi-square and Fisher exact tests, with a reference p-value < 0.05 and a CI of 95%.Results:
Out of 190 patients with BC, 96 (51%) were negative and 94 (49%) were positive for PM as follows 28 (25.5%) BRCA1, 16 (17%) BRCA2, 15 (16%) CHECK2, 14 (14%) RAD Group, 7 (7%) PALB, 6 (6%) NBN, 3 (3%) TP53 and ATM and 2 (2%) BARD1. US was positive in 88 of the patients, 36 with PM and 52 without PM. US and surgery (≥N1 stage) were both positive in 31 (62%) of PM patients and 44 (88%) of patients without genetic changes. There were 19 (61%) false negative US examinations in the PM group and 6 (13%) in the group without genetic changes, respectively. If the US is positive, there is a 2.6 times greater risk of positive nodes in PM patients (p-value < 0.000, 95% CI = 4.2-37.9), and a 6.2 times greater risk of positive nodes in patients without genetic changes (p-value < 0.000, 95%CI = 8.4-37.4). In the PM group, US compared to surgery reached a sensitivity = 62, with PPV = 86 and NPV = 67. In the BRCA1/2 subgroup, there is 2.5 greater times risk of nodal disease if the US is positive (p-value = 0.001, 95%CI = 2.6-76). In patients without PM, US compared to surgery reached a sensitivity = 88, PPV = 84 and NPV = 86.Conclusion:
US is more sensitive in depicting axillary nodal disease in high-risk patients without PM compared to PM patients. Furthermore, there are more false negative US examinations in PM patients, compared to surgery patients.
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Bases de datos:
MEDLINE
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Idioma:
En
Revista:
J Pers Med
Año:
2021
Tipo del documento:
Article
País de afiliación:
Rumanía