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Ultrasound- an Evaluation Tool for Assessment of Breast Tumour and Axillary Lymph Node Size

Received: 8 March 2014    Accepted: 29 April 2014    Published: 30 April 2014
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Abstract

Aims: The present study was taken up in carcinoma breast patients to evaluate clinical examination and Ultrasound in estimating the breast tumour size and axillary lymph node size taking histopathological examination as the gold standard. Material & Methods: The study carried out between December 2008 to June 2010 included thirty seven carcinoma breast patients. Ethics committee clearance obtained. Twenty four patients received neoadjuvant chemotherapy followed by surgery. 13 patients were taken up directly for surgery. Largest dimension of the primary tumour and axillary lymph nodes were assessed clinically, sonologically and histopathologically. Results were analyzed using paired-t test and Pearson correlation coefficient. Results: Clinical examination overestimated breast tumour size, while underestimated axillary lymph node size in majority of the patients. Sonological examination underestimated both breast tumour size and axillary lymph node size in majority of patients. There was strong correlation (r =.719, p=<.001) between clinical and histopathological breast tumour size, however for axillary lymph nodes the correlation was moderate (r=.536, p= .001). A moderate correlation (r=0.601; p=<.001) was observed between sonological and pathological breast tumour size, while strong correlation (r=.652, p <0.001) was found for axillary lymph nodes. For breast tumour, the difference between mean clinical and histopathological size was 0.01cm and statistically not significant (t=.064, p=.949). However, the difference between mean sonological and histopathological size for breast tumour was 1.10cm, and statistically highly significant (t=-3.93, p<.001). For axillary lymph nodes, the difference in mean size between clinical and histopathological assessment was 0.46 cm (p=0.007) as against mean difference of 0.48 cm between sonological and histopathological assessment (p=0.001). Conclusion: In the present study, for primary breast tumour size estimation clinical assessment was as good as histopathological examination, however, ultrasound was found to be inferior. Whereas for axillary lymph node size estimation both clinical assessment and ultrasound were indifferent .

Published in International Journal of Medical Imaging (Volume 2, Issue 3)
DOI 10.11648/j.ijmi.20140203.13
Page(s) 59-62
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Ultrasound, Breast Cancer, Tumor and Lymph Node Assessment

References
[1] Veronesi U, Galimberti V, Zurrida S, Pigatto F, Veronesi P, Robertson C, Paganelli G, Sciascia V, Viale G. Sentinel lymph node biopsy as an indicator for axillary dissection in early breast cancer. Eur J Cancer 2001;37:454-8.
[2] Cowen D, Jacquemier J, Houvenaeghel G, Viens P, Puig B, Bardou VJ, Resbeut M, Maraninchi D. Local and distant recurrence after conservative management of ‘very low-risk’ breast cancer are dependent events: a 10-year follow-up. Int J Radiat Oncol Biol Phys 1998;41:801-7.
[3] Dongen van JA, Bartelink H, Fentiman IS, Lerut T, Mignolet F, Olthuis G, Schueren van der E, Sylvester R, Tong D, Winter J, et al. Factors influencing local relapse and survival and results of salvage treatment after breast-conserving therapy in operable breast cancer: EORTC trial 10801, breast conservation compared with mastectomy in TNM stage I and II breast cancer. Eur J Cancer 1992;28A(4-5):801-5.
[4] Carter CL, Allen C, Henson DE. Relation of tumor size, lymph node status, and survival in 24 740 breast cancer cases. Cancer 1989;63:181-7.
[5] Sobin LH, Wittekind C. TNM Classification of malignant tumours, Breast Tumours (ICD-O C50) 1997.
[6] Critical assessment of the clinical TNM system in breast cancer. Report from the Yorkshire Breast Cancer Group, Br. Med. J. 1980;281:134-6.
[7] Nair MK, Varghese C, Swaminathan A. Cancer: Current scenario intervention strategies and projections for 2015. Burden of disease in India. Background papers. National Commission for Macroeconomics and health, Ministry of Health and Family Welfare, Government of India, New Delhi. Pp. 218-25, 2005.
[8] Veronesi U, Cascinelli N, Greco M, et al. Prognosis of breast cancer patients after mastectomy and dissection of internal mammary nodes. Ann Surg. 1985; 202:702–707.
[9] S.K. Apple, F. Suthar. How do we measure a residual tumor size in Histopathology (the gold standard) after neoadjuvant chemotherapy? The Breast 2006; 15: 370–376.
[10] Chagpar A, Middleton L, Sahin A, et al. Accuracy of physical examination, untrasonography, and mammography in predicting residual pathologic tumor size in patients treated with neoadjuvant chemotherapy. Ann Surg 2006;243:257–264.
[11] Viviana Londero, Massimo Bazzocchi, Chiara Del Frate, Fabio Puglisi, Carla Di Loreto,Giuliana Francescutti, Chiara Zuiani: Locally advanced breast cancer: comparison of mammography, sonography and MR imaging in evaluation of residual disease in women receiving neoadjuvant chemotherapy. Eur Radiol 2004; 14:1371–1379.
[12] Forouhi P, Walsh JS, Anderson TJ, Chetty U: Ultrasonography as a method of measuring breast tumour size and monitoring response to primary systemic treatment. BrJ Surg 81:223-225, 1994.
[13] Cheong Shook Lee, Jin-Gu Bong, Jin-Hyun Park, Yoon Sik Lee, Sun-Mi Paik, et al., The accuracy of the physical examination, mammography and ultrasonography in the assessment of tumor size and axillary lymph node metastasis in breast cancer patient serve as use adjuncts to sentinel node biopsy. Journal of Korean Breast Cancer Society 2003; 6: 87-94.
[14] Raquel Prati, Christina A. Minami, Jeff A. Gornbein, Accuracy of Clinical Evaluation of Locally Advanced Breast Cancer in Patients Receiving Neoadjuvant Chemotherapy. Cancer. 2009; 115(6):1194–1202.
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    Rashmi Singh, Govardhan H. B., Satyajt Pradhan, P. Swain, Anand Kumar, et al. (2014). Ultrasound- an Evaluation Tool for Assessment of Breast Tumour and Axillary Lymph Node Size. International Journal of Medical Imaging, 2(3), 59-62. https://doi.org/10.11648/j.ijmi.20140203.13

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    ACS Style

    Rashmi Singh; Govardhan H. B.; Satyajt Pradhan; P. Swain; Anand Kumar, et al. Ultrasound- an Evaluation Tool for Assessment of Breast Tumour and Axillary Lymph Node Size. Int. J. Med. Imaging 2014, 2(3), 59-62. doi: 10.11648/j.ijmi.20140203.13

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    AMA Style

    Rashmi Singh, Govardhan H. B., Satyajt Pradhan, P. Swain, Anand Kumar, et al. Ultrasound- an Evaluation Tool for Assessment of Breast Tumour and Axillary Lymph Node Size. Int J Med Imaging. 2014;2(3):59-62. doi: 10.11648/j.ijmi.20140203.13

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  • @article{10.11648/j.ijmi.20140203.13,
      author = {Rashmi Singh and Govardhan H. B. and Satyajt Pradhan and P. Swain and Anand Kumar and R. C. Shukla and U. P. Shahi and L. M. Agrawal},
      title = {Ultrasound- an Evaluation Tool for Assessment of Breast Tumour and Axillary Lymph Node Size},
      journal = {International Journal of Medical Imaging},
      volume = {2},
      number = {3},
      pages = {59-62},
      doi = {10.11648/j.ijmi.20140203.13},
      url = {https://doi.org/10.11648/j.ijmi.20140203.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20140203.13},
      abstract = {Aims: The present study was taken up in carcinoma breast patients to evaluate clinical examination and Ultrasound in estimating the breast tumour size and axillary lymph node size taking histopathological examination as the gold standard. Material & Methods: The study carried out between December 2008 to June 2010 included thirty seven carcinoma breast patients. Ethics committee clearance obtained. Twenty four patients received neoadjuvant chemotherapy followed by surgery. 13 patients were taken up directly for surgery. Largest dimension of the primary tumour and axillary lymph nodes were assessed clinically, sonologically and histopathologically. Results were analyzed using paired-t test and Pearson correlation coefficient. Results: Clinical examination overestimated breast tumour size, while underestimated axillary lymph node size in majority of the patients. Sonological examination underestimated both breast tumour size and axillary lymph node size in majority of patients. There was strong correlation (r =.719, p=<.001) between clinical and histopathological breast tumour size, however for axillary lymph nodes the correlation was moderate (r=.536, p= .001). A moderate correlation (r=0.601; p=<.001) was observed between sonological and pathological breast tumour size, while strong correlation (r=.652, p <0.001) was found for axillary lymph nodes. For breast tumour, the difference between mean clinical and histopathological size was 0.01cm and statistically not significant (t=.064, p=.949). However, the difference between mean sonological and histopathological size for breast tumour was 1.10cm, and statistically highly significant (t=-3.93, p<.001). For axillary lymph nodes, the difference in mean size between clinical and histopathological assessment was 0.46 cm (p=0.007) as against mean difference of 0.48 cm between sonological and histopathological assessment (p=0.001). Conclusion: In the present study, for primary breast tumour size estimation clinical assessment was as good as histopathological examination, however, ultrasound was found to be inferior. Whereas for axillary lymph node size estimation both clinical assessment and ultrasound were indifferent .},
     year = {2014}
    }
    

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  • TY  - JOUR
    T1  - Ultrasound- an Evaluation Tool for Assessment of Breast Tumour and Axillary Lymph Node Size
    AU  - Rashmi Singh
    AU  - Govardhan H. B.
    AU  - Satyajt Pradhan
    AU  - P. Swain
    AU  - Anand Kumar
    AU  - R. C. Shukla
    AU  - U. P. Shahi
    AU  - L. M. Agrawal
    Y1  - 2014/04/30
    PY  - 2014
    N1  - https://doi.org/10.11648/j.ijmi.20140203.13
    DO  - 10.11648/j.ijmi.20140203.13
    T2  - International Journal of Medical Imaging
    JF  - International Journal of Medical Imaging
    JO  - International Journal of Medical Imaging
    SP  - 59
    EP  - 62
    PB  - Science Publishing Group
    SN  - 2330-832X
    UR  - https://doi.org/10.11648/j.ijmi.20140203.13
    AB  - Aims: The present study was taken up in carcinoma breast patients to evaluate clinical examination and Ultrasound in estimating the breast tumour size and axillary lymph node size taking histopathological examination as the gold standard. Material & Methods: The study carried out between December 2008 to June 2010 included thirty seven carcinoma breast patients. Ethics committee clearance obtained. Twenty four patients received neoadjuvant chemotherapy followed by surgery. 13 patients were taken up directly for surgery. Largest dimension of the primary tumour and axillary lymph nodes were assessed clinically, sonologically and histopathologically. Results were analyzed using paired-t test and Pearson correlation coefficient. Results: Clinical examination overestimated breast tumour size, while underestimated axillary lymph node size in majority of the patients. Sonological examination underestimated both breast tumour size and axillary lymph node size in majority of patients. There was strong correlation (r =.719, p=<.001) between clinical and histopathological breast tumour size, however for axillary lymph nodes the correlation was moderate (r=.536, p= .001). A moderate correlation (r=0.601; p=<.001) was observed between sonological and pathological breast tumour size, while strong correlation (r=.652, p <0.001) was found for axillary lymph nodes. For breast tumour, the difference between mean clinical and histopathological size was 0.01cm and statistically not significant (t=.064, p=.949). However, the difference between mean sonological and histopathological size for breast tumour was 1.10cm, and statistically highly significant (t=-3.93, p<.001). For axillary lymph nodes, the difference in mean size between clinical and histopathological assessment was 0.46 cm (p=0.007) as against mean difference of 0.48 cm between sonological and histopathological assessment (p=0.001). Conclusion: In the present study, for primary breast tumour size estimation clinical assessment was as good as histopathological examination, however, ultrasound was found to be inferior. Whereas for axillary lymph node size estimation both clinical assessment and ultrasound were indifferent .
    VL  - 2
    IS  - 3
    ER  - 

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Author Information
  • Departments of Radiotherapy and Radiation Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

  • Departments of Radiotherapy and Radiation Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

  • Departments of Radiotherapy and Radiation Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

  • Departments of Radiotherapy and Radiation Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

  • Departments of Radiotherapy and Radiation Medicine Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

  • Department of Radiodiagnosis & Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

  • Departments of Radiotherapy and Radiation Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

  • Departments of Radiotherapy and Radiation Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

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