Author/Editor		Podkrajšek, Maja
Title		Ultrazvočna preiskava pazduhe pri zamejitvi bolezni bolnic z rakom dojk
Type		monografija
Place		Ljubljana
Publisher		Medicinska fakulteta
Publication year		2007
Volume		str. 48
Language		slo
Abstract		Introduction: The most important prognostic factor in patients with breast cancer are metastases to axillary lymph nodes (ALNs). In all patients with metastatic ALNs, axillary lymph node dissection (ALND) is indicated. Over the last decade, sentinel lymph node (SLN) biopsy has been adopted worldwide as an alternative to ALND in staging patients with breast cancer. The SLN biopsy has minimal side effect; however, in all patients with metastases in SLN, a completion ALND is indicated. Our hypothesis was, that it is possible with ultrasound (US) examination of the axilla combined with US- guided fine needle aspiration biopsy (US-FNAB) of suspicious/malignant ALNs to detect ALNs metastases and spare patients one operative procedure (SLN biopsy). Aims of our study were as follows: I) To determine the sensitivity, specificity, positive (PPV) and negative predictive value (NPV) of different radiological characteristics of metastatic spread to the ALNs and to determine which radiological characteristic is the most sensitive. 2) Additionally we wanted to determine the reproducibility of US examination of the axilla by different examiners. 3) Lastly we wanted to determine the added value of the US contrast agent in the US examination of the ALN on sensitivity, specificity, PPV and NPV for detection of ALNs metastases. Patients and methods: Axillary US was performed in 165 patients with cytologically/histologically proven breast cancer in whom SLN biopsy was planned. In 49 patients with US suspicious ALNs (cortex of LN > 3 mm) or US malignant ALNs (LN hypoechogenic and round - L/S diameter < 1,5) US-FNAB was performed. In 33/49 patients with cytologically proven ALNs metastases ALND was performed without prior SLN biopsy. Axillary ultrasound examination was performed using a linear-array transducer with range 1215 MHz and US-FNAB was performed with a 22-G (0,7 mm) needle. (Abstract truncated at 2000 characters)
Descriptors		AXILLA LYMPHATIC METASTASIS BREAST NEOPLASMS NEOPLASM STAGING BIOPSY, NEEDLE SENSITIVITY AND SPECIFICITY ROC CURVE PROGNOSIS