John Kuckelman*, Morgan Barron, Jason Bingham, Andrew Mosier and Vance Sohn
Departments of Surgery and Radiology, Madigan Army Medical Center, USAFulltext PDF
Introduction: Magnetic resonance imaging (MRI) is commonly utilized in treatment planning for breast cancer patients. While axillary lymph node findings are routinely reported in these studies, the utility of these findings remains unclear.Methods: In this retrospective study from 2008-2014, women diagnosed with invasive breast cancer who did not undergo neoadjuvant therapy were reviewed.MRI characteristics of axillary findings were compared to the final pathologic results.Results: 218 of 338 female patients met inclusion criteria and comprised our patient cohort. MRI was found to have a sensitivity and specificity of 49% and 78%, respectively. The negative predictive value was 80% with an accuracy of 71% and a false negative rate of 13.8%. MRI was more often accurate in younger patients (p< 0.04, CI 0.52-1.19) and those whom had a larger number of lymph nodes harvested (p< 0.0001, CI -10.8 to -0.2). True positives had significantly larger primary tumors and a larger number of positive lymph nodes on final pathology.Conclusion: MRI of the axilla is not a reliable tool for axillary staging in women with breast cancer.
Invasive breast cancer; Magnetic resonance imaging; Axillary staging; Sentinel lymph node biopsy
Kuckelman J, Barron M, Bingham J, Mosier A, Sohn V. Pre-Operative MRI Exhibits Limited Utility in Axillary Staging for Breast Cancer. Clin Surg. 2016; 1: 1265.