Is imaging the future of axillary staging in breast cancer?

Abstract:

:Axillary management in patients with breast cancer has become much less invasive with the introduction of sentinel lymph node biopsy (SLNB). However, over 70 % of SLNBs are negative, questioning the generic use of this invasive procedure. Emerging evidence indicates that breast cancer patients with a low axillary burden of disease do not benefit from axillary lymph node dissection (ALND). Non-invasive techniques such as paramagnetic iron oxide contrast-enhanced magnetic resonance imaging (MRI) may provide genuine alternatives to axillary staging and should be evaluated within clinical trials. Selective axillary surgery could then be offered based on imaging findings and for therapeutic intent. This non-operative approach would reduce morbidity further and facilitate interpretation of follow-up imaging. Key Points • Modern imaging and biopsy greatly help the axillary staging of breast cancer. • Superparamagnetic iron oxide (SPIO)-enhanced MRI offers a further advance. • Sentinel lymph node biopsy may become redundant with SPIO-enhanced MRI. • Selective therapeutic axillary surgery should be based upon preoperative imaging findings.

journal_name

Eur Radiol

journal_title

European radiology

authors

Ahmed M,Usiskin SI,Hall-Craggs MA,Douek M

doi

10.1007/s00330-013-3009-5

subject

Has Abstract

pub_date

2014-02-01 00:00:00

pages

288-93

issue

2

eissn

0938-7994

issn

1432-1084

journal_volume

24

pub_type

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