Choosing an optimal algorithm for the assessment of the condition of regional lymph nodes in patients with breast cancer using modern ultrasound diagnostics


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Objective. To develop a diagnostic algorithm for assessing the condition of the axillary lymphatic collector in patients with early stages of breast cancer. Materials and methods. The study included 118 patients with clinical stage T1-2 and the absence of palpable axillary lymph nodes (N0).Results. Elastometric evaluation showed that the shear wave velocity in the axillary lymph nodes averaged 1.54(±0.44) m/s in the case of a benign lesion and 2.94(±1.19) m/s in a metastatic lesion. Thus, the shear wave velocity in the axillary lymph nodes in patients with metastatic nodes differed significantly from that in patients without metastatic lymph nodes. During the ROC analysis, a threshold value of the shear wave velocity was calculated; the model showed sensitivity in detecting metastases in lymph nodes at the rate of 1.85 m/s in 90% (27 out of 30 patients), and specificity in 72.7% (64 out of 88 patients) of cases. The accuracy of the method was 77.1%, positive predictive value was 52.9%, and negative predictive value was 95.5%. Conclusion. The comprehensive ultrasound assessment revealed 27 patients with metastases in the axillary lymph nodes compared to 22patients with nodes detected by B-mode ultrasonography (90% and 73%, respectively). The patients underwent lymphadenectomy, sentinel lymph node biopsy in this case was not performed.

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Sobre autores

Nafset Khakurinova

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: nafset2701@mail.ru
Oncologist, Department of the day hospital (chemotherapeutic and surgical methods of treatment)

Vyacheslav Snitkin

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: snitkinvm@yandex.ru
post-graduate student of the Department of ultrasound diagnostics of the Research Institute of Clinical and Experimental Radiology

Vladimir Sholokhov

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: vnshell@mail.ru
MD, Professor, leading researcher of the Department of ultrasound diagnostics of the Research Institute of Clinical and Experimental Radiology

Alexander Petrovsky

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: alexpetrovsky@hotmail.com
PhD, deputy director for the development of cancer care in the regions, Research Institute of Clinical Oncology

Ramiz Valiev

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: info@ronc.ru
PhD., Head of the Oncological Department of surgical methods of treatment No. 13, Research Institute of Clinical Oncology

Dmitry Avtomonov

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: info@ronc.ru
PhD., assistant of the Department of Oncology, Institute of Clinical Medicine named after N.V. Sklifosovsky

Igor Samoylenko

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: i.samoylenko@ronc.ru
PhD, senior researcher, Oncological Department of surgical methods of treatment No. 12 (oncodermatology)

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