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01.11.2010 | Leitthema

Nichtinvasive bildgebende Verfahren zum präoperativen axillären Lymphknotenstaging beim Mammakarzinom

verfasst von: PD Dr. K. Wasser, A. Schnitzer, J. Brade, S.O. Schoenberg

Erschienen in: Die Radiologie | Ausgabe 11/2010

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Zusammenfassung

Die Wächterlymphknotenbiopsie hat sich in den letzten 10 Jahren für das axilläre Lymphknotenstaging des Mammakarzinoms fest etabliert. Durch präoperative bildgebende Verfahren kann getestet werden, ob sich Patientinnen für eine Wächterlymphknotenbiopsie eignen oder direkt einer axillären Dissektion unterzogen werden sollten. Diese bildgebenden Verfahren müssen sich in erster Linie durch einen hohen positiven Vorhersagewert (PVW) auszeichnen. Die B-Bild-Sonographie ist diesbezüglich bisher am besten evaluiert. Sie liefert eindeutige morphologische Kriterien für einen hohen PVW (>90%). Die Sensitivität liegt dabei allerdings kaum über 50%. Bisher ist nicht erwiesen, dass andere Verfahren wie die Duplexsonographie, die MRT, die CT oder Szintigraphie eine bessere Sensitivität bei hohem PVW liefern. Lediglich für die Positronenemissionstomographie (PET) bestehen Hinweise, dass die Sensitivität gesteigert werden kann. Dies muss durch weitere Studien untermauert werden, zumal das axilläre Lymphknotenstaging mittels PET oder PET/CT eine zunehmende Bedeutung im Rahmen eines initialen Ganzkörperstagings des Mammakarzinoms erlangen wird.

Abe H, Schmidt RA, Kulkarni K et al (2009) Axillary lymph nodes suspicious for breast cancer metastasis: sampling with US-guided 14-gauge core-needle biopsy – clinical experience in 100 patients. Radiology 250:41–49CrossRefPubMed

Bedrosian I, Bedi D, Kuerer HM et al (2003) Impact of clinicopathological factors on sensitivity of axillary ultrasonography in the detection of axillary nodal metastases in patients with breast cancer. Ann Surg Oncol 10:1025–1030CrossRefPubMed

Bergkvist L, Frisell J, Liljegren G et al (2001) Multicentre study of detection and false-negative rates in sentinel node biopsy for breast cancer. Br J Surg 88:1644–1648CrossRefPubMed

Boughey JC, Middleton LP, Harker L et al (2007) Utility of ultrasound and fine-needle aspiration biopsy of the axilla in the assessment of invasive lobular carcinoma of the breast. Am J Surg 194:450–455CrossRefPubMed

Choi YJ, Ko EY, Han BK et al (2009) High-resolution ultrasonographic features of axillary lymph node metastasis in patients with breast cancer. Breast 18:119–122CrossRefPubMed

Ciatto S, Brancato B, Risso G et al (2007) Accuracy of fine needle aspiration cytology (FNAC) of axillary lymph nodes as a triage test in breast cancer staging. Breast Cancer Res Treat 103:85–91CrossRefPubMed

Damera A, Evans AJ, Cornford EJ et al (2003) Diagnosis of axillary nodal metastases by ultrasound-guided core biopsy in primary operable breast cancer. Br J Cancer 89:1310–1313CrossRefPubMed

Dose J, Bleckmann C, Bachmann S et al (2002) Comparison of fluorodeoxyglucose positron emission tomography and „conventional diagnostic procedures“ for the detection of distant metastases in breast cancer patients. Nucl Med Commun 23:857–864CrossRefPubMed

Esen G, Gurses B, Yilmaz MH et al (2005) Gray scale and power Doppler US in the preoperative evaluation of axillary metastases in breast cancer patients with no palpable lymph nodes. Eur Radiol 15:1215–1223CrossRefPubMed

10.

Feu J, Tresserra F, Fabregas R et al (1997) Metastatic breast carcinoma in axillary lymph nodes: in vitro US detection. Radiology 205:831–835PubMed

11.

Flynn K, Adams E (1996) MDRC Technology Assessment Program: Report No 1 – Assessing Diagnostic technologies. Health Services Research and Development Service, Management Decision and Research Center. http://www4.va.gov/VATAP/docs/AssessingDiagnosticTechnologies1996tagnem.pdf

12.

Gil-Rendo A, Zornoza G, Garcia-Velloso MJ et al (2006) Fluorodeoxyglucose positron emission tomography with sentinel lymph node biopsy for evaluation of axillary involvement in breast cancer. Br J Surg 93:707–712CrossRefPubMed

13.

Greco M, Crippa F, Agresti R et al (2001) Axillary lymph node staging in breast cancer by 2-fluoro-2-deoxy-D-glucose-positron emission tomography: clinical evaluation and alternative management. J Natl Cancer Inst 93:630–635CrossRefPubMed

14.

Guenther JM, Krishnamoorthy M, Tan LR (1997) Sentinel lymphadenectomy for breast cancer in a community managed care setting. Cancer J Sci Am 3:336–340PubMed

15.

Haberkorn U (2008) Onkologie. Unspezifische Radiopharmaka. In: Kuwert T, Grünwald F, Haberkon U, Krause T (Hrsg) Nuklearmedizin. Thieme, Stuttgart New York, S 153–191

16.

Harada T, Tanigawa N, Matsuki M et al (2007) Evaluation of lymph node metastases of breast cancer using ultrasmall superparamagnetic iron oxide-enhanced magnetic resonance imaging. Eur J Radiol 63:401–407CrossRefPubMed

17.

Heesakkers RA, Hovels AM, Jager GJ et al (2008) MRI with a lymph-node-specific contrast agent as an alternative to CT scan and lymph-node dissection in patients with prostate cancer: a prospective multicohort study. Lancet Oncol 9:850–856CrossRefPubMed

18.

Kim J, Lee J, Chang E et al (2009) Selective sentinel node plus additional non-sentinel node biopsy based on an FDG-PET/CT scan in early breast cancer patients: Single institutional experience. World J Surg 33:943–949CrossRefPubMed

19.

Knopp MV, Obier C, Zuna I et al (1998) Multiple reader analysis for evaluation of functional MR mammography. Radiologe 38:307–314CrossRefPubMed

20.

Krishnamurthy S, Sneige N, Bedi DG et al (2002) Role of ultrasound-guided fine-needle aspiration of indeterminate and suspicious axillary lymph nodes in the initial staging of breast carcinoma. Cancer 95:982–988CrossRefPubMed

21.

Kuehn T, Bembenek A, Decker T et al (2005) A concept for the clinical implementation of sentinel lymph node biopsy in patients with breast carcinoma with special regard to quality assurance. Cancer 103:451–461CrossRefPubMed

22.

Kuhl CK, Mielcareck P, Klaschik S et al (1999) Dynamic breast MR imaging: are signal intensity time course data useful for differential diagnosis of enhancing lesions? Radiology 211:101–110PubMed

23.

Kumar R, Zhuang H, Schnall M et al (2006) FDG PET positive lymph nodes are highly predictive of metastasis in breast cancer. Nucl Med Commun 27:231–236CrossRefPubMed

24.

Kvistad KA, Rydland J, Smethurst HB et al (2000) Axillary lymph node metastases in breast cancer: preoperative detection with dynamic contrast-enhanced MRI. Eur Radiol 10:1464–1471CrossRefPubMed

25.

Leibman AJ, Wong R (1997) Findings on mammography in the axilla. AJR Am J Roentgenol 169:1385–1390PubMed

26.

Luciani A, Dao TH, Lapeyre M et al (2004) Simultaneous bilateral breast and high-resolution axillary MRI of patients with breast cancer: preliminary results. AJR Am J Roentgenol 182:1059–1067PubMed

27.

Lumachi F, Tregnaghi A, Ferretti G et al (2006) Accuracy of ultrasonography and 99mTc-sestamibi scintimammography for assessing axillary lymph node status in breast cancer patients. A prospective study. Eur J Surg Oncol 32:933–936CrossRefPubMed

28.

March DE, Wechsler RJ, Kurtz AB et al (1991) CT-pathologic correlation of axillary lymph nodes in breast carcinoma. J Comput Assist Tomogr 15:440–444CrossRefPubMed

29.

Mathijssen IM, Strijdhorst H, Kiestra SK, Wereldsma JC (2006) Added value of ultrasound in screening the clinically negative axilla in breast cancer. J Surg Oncol 94:364–367CrossRefPubMed

30.

Michel SC, Keller TM, Frohlich JM et al (2002) Preoperative breast cancer staging: MR imaging of the axilla with ultrasmall superparamagnetic iron oxide enhancement. Radiology 225:527–536CrossRefPubMed

31.

Mumtaz H, Hall-Craggs MA, Davidson T et al (1997) Staging of symptomatic primary breast cancer with MR imaging. AJR Am J Roentgenol 169:417–424PubMed

32.

Murray AD, Staff RT, Redpath TW et al (2002) Dynamic contrast enhanced MRI of the axilla in women with breast cancer: comparison with pathology of excised nodes. Br J Radiol 75:220–228PubMed

33.

Mustonen P, Farin P, Kosunen O (1990) Ultrasonographic detection of metastatic axillary lymph nodes in breast cancer. Ann Chir Gynaecol 79:15–18PubMed

34.

Nori J, Vanzi E, Bazzocchi M et al (2007) Role of axillary ultrasound examination in the selection of breast cancer patients for sentinel node biopsy. Am J Surg 193:16–20CrossRefPubMed

35.

Ogasawara Y, Doihara H, Shiraiwa M, Ishihara S (2008) Multidetector-row computed tomography for the preoperative evaluation of axillary nodal status in patients with breast cancer. Surg Today 38:104–108CrossRefPubMed

36.

Podkrajsek M, Music MM, Kadivec M et al (2005) Role of ultrasound in the preoperative staging of patients with breast cancer. Eur Radiol 15:1044–1050CrossRefPubMed

37.

Port ER, Yeung H, Gonen M et al (2006) 18F-2-fluoro-2-deoxy-D-glucose positron emission tomography scanning affects surgical management in selected patients with high-risk, operable breast carcinoma. Ann Surg Oncol 13:677–684CrossRefPubMed

38.

Sato K, Tamaki K, Tsuda H et al (2004) Utility of axillary ultrasound examination to select breast cancer patients suited for optimal sentinel node biopsy. Am J Surg 187:679–683CrossRefPubMed

39.

Schirrmeister H, Kuhn T, Guhlmann A et al (2001) Fluorine-18 2-deoxy-2-fluoro-D-glucose PET in the preoperative staging of breast cancer: comparison with the standard staging procedures. Eur J Nucl Med 28:351–358CrossRefPubMed

40.

Seenu V, Pavan Kumar MN, Sharma U et al (2005) Potential of magnetic resonance spectroscopy to detect metastasis in axillary lymph nodes in breast cancer. Magn Reson Imaging 23:1005–1010CrossRefPubMed

41.

Sharma U, Mehta A, Seenu V, Jagannathan NR (2004) Biochemical characterization of metastatic lymph nodes of breast cancer patients by in vitro 1H magnetic resonance spectroscopy: a pilot study. Magn Reson Imaging 22:697–706CrossRefPubMed

42.

Sigal R, Vogl T, Casselman J et al (2002) Lymph node metastases from head and neck squamous cell carcinoma: MR imaging with ultrasmall superparamagnetic iron oxide particles (sinerem MR) – results of a phase-III multicenter clinical trial. Eur Radiol 12:1104–1113CrossRefPubMed

43.

Sloka JS, Hollett PD, Mathews M (2007) A quantitative review of the use of FDG-PET in the axillary staging of breast cancer. Med Sci Monit 13:RA37–RA46PubMed

44.

Specht MC, Fey JV, Borgen PI, Cody HS 3rd (2005) Is the clinically positive axilla in breast cancer really a contraindication to sentinel lymph node biopsy? J Am Coll Surg 200:10–14CrossRefPubMed

45.

Stadnik TW, Everaert H, Makkat S et al (2006) Breast imaging. Preoperative breast cancer staging: comparison of USPIO-enhanced MR imaging and 18F-fluorodeoxyglucose (FDC) positron emission tomography (PET) imaging for axillary lymph node staging–initial findings. Eur Radiol 16:2153–2160CrossRefPubMed

46.

Taillefer R (1999) The role of 99mTc-sestamibi and other conventional radiopharmaceuticals in breast cancer diagnosis. Semin Nucl Med 29:16–40CrossRefPubMed

47.

Taillefer R, Robidoux A, Turpin S et al (1998) Metastatic axillary lymph node technetium-99m-MIBI imaging in primary breast cancer. J Nucl Med 39:459–464PubMed

48.

Ueda S, Tsuda H, Asakawa H et al (2008) Utility of 18F-fluoro-deoxyglucose emission tomography/computed tomography fusion imaging (18F-FDG PET/CT) in combination with ultrasonography for axillary staging in primary breast cancer. BMC Cancer 8:165CrossRefPubMed

49.

Veronesi U, De Cicco C, Galimberti VE et al (2007) A comparative study on the value of FDG-PET and sentinel node biopsy to identify occult axillary metastases. Ann Oncol 18:473–478CrossRefPubMed

50.

Veronesi U, Paganelli G, Viale G et al (2003) A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med 349:546–553CrossRefPubMed

51.

Wahl RL, Siegel BA, Coleman RE, Gatsonis CG (2004) Prospective multicenter study of axillary nodal staging by positron emission tomography in breast cancer: a report of the staging breast cancer with PET study group. J Clin Oncol 22:277–285CrossRefPubMed

52.

Walsh R, Kornguth PJ, Soo MS et al (1997) Axillary lymph nodes: mammographic, pathologic, and clinical correlation. AJR Am J Roentgenol 168:33–38PubMed

53.

Weissleder R, Elizondo G, Wittenberg J et al (1990) Ultrasmall superparamagnetic iron oxide: characterization of a new class of contrast agents for MR imaging. Radiology 175:489–493PubMed

54.

Yang WT, Chang J, Metreweli C (2000) Patients with breast cancer: differences in color Doppler flow and gray-scale US features of benign and malignant axillary lymph nodes. Radiology 215:568–573PubMed

55.

Yeung DK, Yang WT, Tse GM (2002) Breast cancer: in vivo proton MR spectroscopy in the characterization of histopathologic subtypes and preliminary observations in axillary node metastases. Radiology 225:190–197CrossRefPubMed

56.

Yoshimura G, Sakurai T, Oura S et al (1999) Evaluation of axillary lymph node status in breast cancer with MRI. Breast Cancer 6:249–258CrossRefPubMed

57.

Zornoza G, Garcia-Velloso MJ, Sola J et al (2004) 18F-FDG PET complemented with sentinel lymph node biopsy in the detection of axillary involvement in breast cancer. Eur J Surg Oncol 30:15–19CrossRefPubMed

Titel: Nichtinvasive bildgebende Verfahren zum präoperativen axillären Lymphknotenstaging beim Mammakarzinom
verfasst von: PD Dr. K. Wasser
A. Schnitzer
J. Brade
S.O. Schoenberg
Publikationsdatum: 01.11.2010
Verlag: Springer-Verlag
Erschienen in: Die Radiologie / Ausgabe 11/2010
Print ISSN: 2731-7048
Elektronische ISSN: 2731-7056
DOI: https://doi.org/10.1007/s00117-010-2072-z

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Nichtinvasive bildgebende Verfahren zum präoperativen axillären Lymphknotenstaging beim Mammakarzinom

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