U/S helps predict breast Ca recurrences and metastasis

Ultrasonography of the lymph nodes can detect disease recurrence and help predict the development of distant metastases in women who have had surgery for breast cancer, according to a study in the September issue of Radiology.

Hee Jung Moon, MD, of Yonsei University College of Medicine in Seoul, South Korea, and colleagues performed ultrasonography imaging on the lymph nodes of 1,817 women who had undergone breast surgery. The ultrasonography imaging was evaluated for detection of lymph node recurrence (LNR). The incidence of distant metastases in patients with ipsilateral LNR was compared to the incidence of metastases without LNR.

In at least 12 months of follow-up, the researchers found that 39 of the patients had LNR, of whom 11 had ipsilateral LNR only. For detecting LNR, ultrasonography had a sensitivity of 76.9%, specificity of 98.7%, accuracy of 98.2%, positive predictive value of 55.6%, and negative predictive value of 99.5%. Distant metastases occurred more in patients with ipsilateral LNR (62%) than in those without (2.3%).

“On the basis of our study findings, ipsilateral axillary or supraclavicular LNR was a useful predictor of concurrent or subsequent distant metastasis. Thus, imaging surveillance for distant metastases should be performed in patients with ipsilateral LNR. Lymph node ultrasonography of the bilateral axillary and supraclavicular lymph node areas is useful for early detection of ipsilateral and contralateral LNR in the absence of symptoms,” the authors write.

Moon HJ, Kim MJ, Kim EK, et al. US surveillance of regional lymph node recurrence after breast cancer surgery. Radiology. 2009;252:673-681.