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Breast cancer subtypes affect the ultrasound performance for axillary lymph node status evaluation after neoadjuvant chemotherapy: a retrospective analysis
Japanese Journal of Clinical Oncology ( IF 2.4 ) Pub Date : 2021-08-03 , DOI: 10.1093/jjco/hyab117
Jie Fei 1 , Guan Qun Wang 2 , Yuan Yuan Meng 3 , Xin Zhong 4 , Jin Zhu Ma 1 , Ning Ning Sun 5 , Jing Jing Chen 1
Affiliation  

Abstract
Purpose
The aim of our study was to investigate the effect of breast cancer subtypes on the diagnostic value of axillary ultrasound for node status evaluation after neoadjuvant chemotherapy.
Patients and methods
Pathologic node-positive breast cancer patients underwent axillary ultrasound imaging after neoadjuvant chemotherapy were retrospectively reviewed. The enrolled patients were classified into four subtypes: Luminal A, Luminal B, human epidermal growth factor receptor 2-enriched and triple-negative. Ultrasound images of axillary nodes were reviewed and were evaluated as normal or abnormal and were associated with final pathologic results. Diagnostic value of axillary ultrasound was assessed in four subtypes based on sensitivity, specificity, positive predictive value and negative predictive value. The diagnostic value of axillary ultrasound as well as clinical and pathological characteristics was compared between four breast cancer subtypes using chi-square test or fisher’s exact test.
Result
Luminal A subtype had highest positive predictive value (92.1%), lowest sensitivity (43.8%) and lowest negative predictive value (11.8%). Triple-negative subtype had lowest positive predictive value (73.2%), highest sensitivity (76.9%) and highest negative predictive value (59.1%) (P < 0.05). Luminal B and human epidermal growth factor receptor 2-enriched subtypes had medium sensitivity, positive predictive value and negative predictive value.
Conclusion
The diagnostic value of axillary ultrasound for node residue disease assessment after neoadjuvant chemotherapy is different between four breast cancer subtypes.


中文翻译:

乳腺癌亚型影响新辅助化疗后腋窝淋巴结状态评估的超声表现:回顾性分析

摘要
目的
我们研究的目的是探讨乳腺癌亚型对新辅助化疗后腋窝超声对淋巴结状态评估诊断价值的影响。
患者和方法
回顾性分析了新辅助化疗后接受腋窝超声检查的病理淋巴结阳性乳腺癌患者。纳入的患者分为四种亚型:Luminal A、Luminal B、人表皮生长因子受体 2 富集型和三阴性。回顾腋窝淋巴结超声图像,评估正常或异常,并与最终病理结果相关联。根据敏感性、特异性、阳性预测值和阴性预测值四个亚型评估腋窝超声的诊断价值。使用卡方检验或Fisher精确检验比较四种乳腺癌亚型的腋窝超声诊断价值以及临床和病理特征。
结果
Luminal A 亚型具有最高的阳性预测值 (92.1%)、最低的敏感性 (43.8%) 和最低的阴性预测值 (11.8%)。三阴性亚型的阳性预测值最低(73.2%)、敏感性最高(76.9%)和阴性预测值最高(59.1%)(P  < 0.05)。Luminal B 和人表皮生长因子受体 2 富集亚型具有中等敏感性、阳性预测值和阴性预测值。
结论
腋窝超声对新辅助化疗后淋巴结残留病变评估的诊断价值在四种乳腺癌亚型之间存在差异。
更新日期:2021-10-07
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