Axillary Lymph Node Metastasis Detection by Magnetic Resonance Imaging in Patients with Breast Cancer: A Meta-analysis

Overview

Journal Thorac Cancer

Specialties Oncology
Pulmonary Medicine

Date 2018 Jun 8

PMID 29877048

Citations 15

Authors

Peng Zhou

Yongqing Wei

Guoyue Chen

Lei Guo

Deyue Yan

Ying Wang

Affiliations

Soon will be listed here.

Abstract

Background: The study was conducted to evaluate the diagnostic performance of magnetic resonance imaging (MRI) for the detection of axillary lymph node metastasis in patients with breast cancer.

Methods: PubMed, Medline, Web of Science, Cochrane Embase, Chinese Biomedical Literature, and China National Knowledge Infrastructure databases were searched for open published studies relevant to the use of MRI for the detection of axillary lymph node metastasis in breast cancer patients. The pooled diagnostic sensitivity, specificity, and the symmetric receiver operating characteristic (SROC) curve was calculated by combining the individual data extracted from 26 included studies.

Results: The pooled diagnostic sensitivity and specificity of MRI to detect axillary lymph node metastasis in patients with breast cancer were 0.77 (95% confidence interval [CI] 0.75-0.80) and 0.90 (95% CI 0.89-0.91), respectively. The pooled positive and negative likelihood ratios were 7.67 (95% CI 5.09-11.53) and 0.23 (95% CI 0.17-0.32), respectively, by random effect method. The area under the SROC curve was 0.93 for MRI to detect axillary lymph node metastasis in breast cancer patients.

Conclusion: With high sensitivity, specificity, and area under the curve, MRI is an effective method to differentiate metastatic axillary lymph node in breast cancer patients, which can provide useful information for surgical procedure selection.

Citing Articles

Axillary lymph node metastasis in breast cancer: from historical axillary surgery to updated advances in the preoperative diagnosis and axillary management.

Wu T, Long Q, Zeng L, Zhu J, Gao H, Deng Y BMC Surg. 2025; 25(1):81.

PMID: 40016717 PMC: 11869450. DOI: 10.1186/s12893-025-02802-2.

Development and Validation of a Nomogram for Axillary Lymph Node Metastasis Risk in Breast Cancer.

Wang S, Zhang H, Wang X, Yu J, Zhang Q, Zheng Y J Cancer. 2024; 15(18):6122-6134.

PMID: 39440057 PMC: 11493017. DOI: 10.7150/jca.100651.

Diagnostic performance of MRI for assessing axillary lymph node status after neoadjuvant chemotherapy in breast cancer: a systematic review and meta-analysis.

Li Z, Ma Q, Gao Y, Qu M, Li J, Lei J Eur Radiol. 2023; 34(2):930-942.

PMID: 37615764 DOI: 10.1007/s00330-023-10155-8.

Diagnostic accuracy of pre-operative breast magnetic resonance imaging (MRI) in predicting axillary lymph node metastasis: variations in intrinsic subtypes, and strategy to improve negative predictive value-an analysis of 2473 invasive breast cancer....

Chen S, Lai H, Chang J, Liao C, Wen T, Wu W Breast Cancer. 2023; 30(6):976-985.

PMID: 37500823 PMC: 10587219. DOI: 10.1007/s12282-023-01488-9.

Deep learning applications to breast cancer detection by magnetic resonance imaging: a literature review.

Adam R, DellAquila K, Hodges L, Maldjian T, Duong T Breast Cancer Res. 2023; 25(1):87.

PMID: 37488621 PMC: 10367400. DOI: 10.1186/s13058-023-01687-4.

References

Fornasa F, Nesoti M, Bovo C, Bonavina M . Diffusion-weighted magnetic resonance imaging in the characterization of axillary lymph nodes in patients with breast cancer. J Magn Reson Imaging. 2012; 36(4):858-64. DOI: 10.1002/jmri.23706. View

Luo N, Su D, Jin G, Liu L, Zhu X, Xie D . Apparent diffusion coefficient ratio between axillary lymph node with primary tumor to detect nodal metastasis in breast cancer patients. J Magn Reson Imaging. 2013; 38(4):824-8. DOI: 10.1002/jmri.24031. View

Kim E, Kim S, Kang B, Choi B, Song B, Choi J . Diagnostic value of breast MRI for predicting metastatic axillary lymph nodes in breast cancer patients: diffusion-weighted MRI and conventional MRI. Magn Reson Imaging. 2014; 32(10):1230-6. DOI: 10.1016/j.mri.2014.07.001. View

Harada T, Tanigawa N, Matsuki M, Nohara T, Narabayashi I . Evaluation of lymph node metastases of breast cancer using ultrasmall superparamagnetic iron oxide-enhanced magnetic resonance imaging. Eur J Radiol. 2007; 63(3):401-7. DOI: 10.1016/j.ejrad.2007.02.010. View

Li C, Meng S, Yang X, Wang J, Hu J . The value of T2* in differentiating metastatic from benign axillary lymph nodes in patients with breast cancer--a preliminary in vivo study. PLoS One. 2014; 9(1):e84038. PMC: 3894179. DOI: 10.1371/journal.pone.0084038. View

Michel S, Keller T, Frohlich J, Fink D, Caduff R, Seifert B . Preoperative breast cancer staging: MR imaging of the axilla with ultrasmall superparamagnetic iron oxide enhancement. Radiology. 2002; 225(2):527-36. DOI: 10.1148/radiol.2252011605. View

Siegel R, Miller K, Jemal A . Cancer statistics, 2018. CA Cancer J Clin. 2018; 68(1):7-30. DOI: 10.3322/caac.21442. View

Kvistad K, Rydland J, Smethurst H, Lundgren S, Fjosne H, Haraldseth O . Axillary lymph node metastases in breast cancer: preoperative detection with dynamic contrast-enhanced MRI. Eur Radiol. 2000; 10(9):1464-71. DOI: 10.1007/s003300000370. View

Jessing C, Langhans L, Jensen M, Talman M, Tvedskov T, Kroman N . Axillary lymph node dissection in breast cancer patients after sentinel node biopsy<sup/>. Acta Oncol. 2017; 57(1):166-169. DOI: 10.1080/0284186X.2017.1401227. View

10.

Siegel R, Miller K, Jemal A . Cancer Statistics, 2017. CA Cancer J Clin. 2017; 67(1):7-30. DOI: 10.3322/caac.21387. View

11.

Li S, Wang X, Yang J, Lv M, Zhang X, Li C . Clinicopathological features and survival of early stage breast cancer in northwest China: A population-based retrospective study of 1287 patients. Thorac Cancer. 2017; 9(1):10-18. PMC: 5754296. DOI: 10.1111/1759-7714.12503. View

12.

He N, Xie C, Wei W, Pan C, Wang W, Lv N . A new, preoperative, MRI-based scoring system for diagnosing malignant axillary lymph nodes in women evaluated for breast cancer. Eur J Radiol. 2012; 81(10):2602-12. DOI: 10.1016/j.ejrad.2012.03.019. View

13.

Kinne D . Axillary clearance in operable breast cancer: still a necessity?. Recent Results Cancer Res. 1999; 152:161-9. DOI: 10.1007/978-3-642-45769-2_15. View

14.

Mumtaz H, Hall-Craggs M, Davidson T, Walmsley K, Thurell W, Kissin M . Staging of symptomatic primary breast cancer with MR imaging. AJR Am J Roentgenol. 1997; 169(2):417-24. DOI: 10.2214/ajr.169.2.9242745. View

15.

Javid S, Segara D, Lotfi P, Raza S, Golshan M . Can breast MRI predict axillary lymph node metastasis in women undergoing neoadjuvant chemotherapy. Ann Surg Oncol. 2010; 17(7):1841-6. DOI: 10.1245/s10434-010-0934-2. View

16.

Memarsadeghi M, Riedl C, Kaneider A, Galid A, Rudas M, Matzek W . Axillary lymph node metastases in patients with breast carcinomas: assessment with nonenhanced versus uspio-enhanced MR imaging. Radiology. 2006; 241(2):367-77. DOI: 10.1148/radiol.2412050693. View

17.

Nakai G, Matsuki M, Harada T, Tanigawa N, Yamada T, Barentsz J . Evaluation of axillary lymph nodes by diffusion-weighted MRI using ultrasmall superparamagnetic iron oxide in patients with breast cancer: initial clinical experience. J Magn Reson Imaging. 2011; 34(3):557-62. DOI: 10.1002/jmri.22651. View

18.

Motomura K, Ishitobi M, Komoike Y, Koyama H, Noguchi A, Sumino H . SPIO-enhanced magnetic resonance imaging for the detection of metastases in sentinel nodes localized by computed tomography lymphography in patients with breast cancer. Ann Surg Oncol. 2011; 18(12):3422-9. DOI: 10.1245/s10434-011-1710-7. View

19.

Kamitani T, Hatakenaka M, Yabuuchi H, Matsuo Y, Fujita N, Jinnouchi M . Detection of axillary node metastasis using diffusion-weighted MRI in breast cancer. Clin Imaging. 2012; 37(1):56-61. DOI: 10.1016/j.clinimag.2012.02.014. View

20.

Siegel R, Miller K, Jemal A . Cancer statistics, 2016. CA Cancer J Clin. 2016; 66(1):7-30. DOI: 10.3322/caac.21332. View