For patients diagnosed with breast cancer, determining whether cancer cells have spread to the axillary lymph nodes of the armpit is important for guiding treatment decisions. It has been debated whether axillary ultrasound imaging is equally sensitive for detecting axillary metastatic lymph nodes in different subtypes of breast cancer.
A new BJS (British Journal of Surgery) study indicates that axillary ultrasound imaging is inferior for detecting axillary node metastasis in patients with invasive lobular carcinoma compared with invasive ductal carcinoma. Therefore, women with invasive lobular carcinoma may benefit from axillary biopsies regardless of the ultrasonographic appearance of the nodes.
The study included women diagnosed with invasive lobular carcinoma (602 women) or invasive ductal carcinoma (4199 women) in the West of Scotland in 2012-2014.
"Accurate preoperative staging of the axilla is important to allow decisions regarding neoadjuvant therapy to be made; it is also an important factor in the planning of postmastectomy radiotherapy and consequently may affect reconstructive options," wrote the authors.
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E. Morrow et al, Population-based study of the sensitivity of axillary ultrasound imaging in the preoperative staging of node-positive invasive lobular carcinoma of the breast, British Journal of Surgery (2018). DOI: 10.1002/bjs.10791