The role of ultrasound and lymphoscintigraphy in the assessment of axillary lymph nodes in patients with breast cancer

• Authors: Michał Nieciecki , Katarzyna Dobruch-Sobczak , Paweł Wareluk , Anna Gumińska , Ewa Białek , Marek Cacko , Leszek Królicki

Title variants

PL

Rola badania ultrasonograficznego oraz limfoscyntygrafii w diagnostyce węzłów chłonnych pachowych u pacjentek z rakiem piersi

• Languages of publication: EN PL

Abstracts

EN

Breast cancer is the most common malignancy and the leading cause of death due to cancer in European women. Mammography screening programs aimed to increase the detection of early cancer stages were implemented in numerous European countries. Recent data show a decrease in mortality due to breast cancer in many countries, particularly among young women. At the same time, the number of sentinel node biopsy procedures and breast-conserving surgeries has increased. Intraoperative sentinel lymph node biopsy preceded by lymphoscintigraphy is used in breast cancer patients with no clinical signs of lymph node metastasis. Due to the limited sensitivity and specificity of physical examination in detecting metastatic lesions, developing an appropriate diagnostic algorithm for the preoperative assessment of axillary lymph nodes seems to be a challenge. The importance of ultrasound in patient qualification for sentinel lymph-node biopsy has been discussed in a number of works. Furthermore, different lymphoscintigraphy protocols have been compared in the literature. The usefulness of novel radiopharmaceuticals as well as the methods of image acquisition in sentinel lymph node diagnostics have also been assessed. The aim of this article is to present, basing on current guidelines, literature data as well as our own experience, the diagnostic possibilities of axillary lymph node ultrasound in patient qualification for an appropriate treatment as well as the role of lymphoscintigraphy in sentinel lymph node biopsy.

PL

Rak piersi jest najczęściej występującym nowotworem złośliwym i jednocześnie najczęstszą przyczyną zgonów z powodu chorób nowotworowych u kobiet w Europie. W kilkunastu krajach europejskich wprowadzano programy przesiewowych badań mammograficznych, mające przyczynić się do zwiększenia wykrywalności zmian nowotworowych o małym stopniu zaawansowania. Ostatnie dane wskazują, że w wielu z tych państw występuje spadek śmiertelności z powodu raka piersi, szczególnie w grupie kobiet młodych. Zwiększeniu ulega natomiast liczba procedur biopsji węzła wartowniczego i operacji oszczędzających. Śródoperacyjne pobranie węzła wartowniczego, poprzedzone badaniem limfoscyntygraficznym, stosuje się u chorych na raka piersi bez klinicznych cech przerzutów w węzłach chłonnych. Ze względu na ograniczoną czułość i swoistość badania fizykalnego w wykrywaniu tego typu zmian wyzwaniem wydaje się opracowanie właściwego algorytmu diagnostycznego w przedoperacyjnej ocenie węzłów chłonnych pachowych. Tematem szeregu prac jest znaczenie badania ultrasonograficznego w kwalifikacji pacjentek do biopsji węzła wartowniczego. W piśmiennictwie porównywane są także różne protokoły limfoscyntygrafii. Ocenie podlega też przydatność nowych radiofarmaceutyków oraz metod akwizycji obrazu w diagnostyce wartowniczych węzłów chłonnych. Celem artykułu jest przedstawienie – na podstawie aktualnych wytycznych, danych z piśmiennictwa oraz doświadczeń własnych autorów – możliwości diagnostycznych badania ultrasonograficznego węzłów chłonnych pachowych w kwalifikacji chorych do odpowiedniego leczenia oraz roli limfoscyntygrafii w procedurze biopsji węzła wartowniczego.

Keywords

EN

axillary lymph nodes; breast cancer; limfoscyntygrafia; lymphoscintigraphy; rak piersi; sentinel lymph node; ultrasonografia; ultrasound; węzeł wartowniczy; węzły chłonne pachowe

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Journal of Ultrasonography
• Year: 2016
• Volume: 16
• Issue: 64
• Pages: 5–15

Contributors

author

Michał Nieciecki

• Department of Diagnostic Imaging, Mazovian Bródno Hospital, Warsaw, Poland

author

Katarzyna Dobruch-Sobczak

• Department of Radiology, Centre of Oncology, Maria Skłodowska-Curie Memorial Institute, Warsaw, Poland

author

Paweł Wareluk

• Department of Diagnostic Imaging, Medical University of Warsaw, Warsaw, Poland

author

Anna Gumińska

• Department of Nuclear Medicine and Endocrine Oncology, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland

author

Ewa Białek

• Department of Diagnostic Imaging, Medical University of Warsaw, Warsaw, Poland

author

Marek Cacko

• Department of Diagnostic Imaging, Mazovian Bródno Hospital, Warsaw, Poland

author

Leszek Królicki

• Department of Diagnostic Imaging, Mazovian Bródno Hospital, Warsaw, Poland. Department of Nuclear Medicine, Medical University of Warsaw, Warsaw, Poland

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• Document Type: review