Role of ultrasonography of regional nodal basins in staging triple-negative breast cancer and implications for Local-Regional Treatment Part of the findings herein were presented at the 56th Annual Meeting of the American Society of Radiation Oncology, San Francisco, CA, Sep 2014.

Simona F. Shaitelman, Welela Tereffe, Basak E. Dogan, Kenneth R. Hess, Abigail S. Caudle, Vicente Valero, Michael C. Stauder, Savitri Krishnamurthy, Rosalind P. Candelaria, Eric A. Strom, Wendy A. Woodward, Kelly K. Hunt, Thomas A. Buchholz, Gary J. Whitman

Research output: Contribution to journalArticle

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Abstract

Purpose We sought to determine the rate at which regional nodal ultrasonography would increase the nodal disease stage in patients with triple-negative breast cancer (TNBC) beyond the clinical stage determined by physical examination and mammography alone, and significantly affect the treatments delivered to these patients. Methods and Materials We retrospectively reviewed the charts of women with stages I to III TNBC who underwent physical examination, mammography, breast and regional nodal ultrasonography with needle biopsy of abnormal nodes, and definitive local-regional treatment at our institution between 2004 and 2011. The stages of these patients' disease with and without ultrasonography of the regional nodal basins were compared using the Pearson χ2 test. Definitive treatments of patients whose nodal disease was upstaged on the basis of ultrasonographic findings were compared to those of patients whose disease stage remained the same. Results A total of 572 women met the study requirements. In 111 (19.4%) of these patients, regional nodal ultrasonography with needle biopsy resulted in an increase in disease stage from the original stage by physical examination and mammography alone. Significantly higher percentages of patients whose nodal disease was upstaged by ultrasonographic findings compared to that in patients whose disease was not upstaged underwent neoadjuvant systemic therapy (91.9% and 51.2%, respectively; P<.0001), axillary lymph node dissection (99.1% and 34.5%, respectively; P<.0001), and radiation to the regional nodal basins (88.2% and 29.1%, respectively; P<.0001). Conclusions Regional nodal ultrasonography in TNBC frequently changes the initial clinical stage and plays an important role in treatment planning.

Original languageEnglish (US)
Pages (from-to)102-110
Number of pages9
JournalInternational Journal of Radiation Oncology Biology Physics
Volume93
Issue number1
DOIs
StatePublished - Jan 1 2015

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Triple Negative Breast Neoplasms
Radiation Oncology
San Francisco
breast
Ultrasonography
cancer
physical examinations
radiation
Mammography
Physical Examination
Needle Biopsy
Therapeutics
needles
dissection
Neoadjuvant Therapy
lymphatic system
charts
Lymph Node Excision
planning
therapy

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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Role of ultrasonography of regional nodal basins in staging triple-negative breast cancer and implications for Local-Regional Treatment Part of the findings herein were presented at the 56th Annual Meeting of the American Society of Radiation Oncology, San Francisco, CA, Sep 2014. / Shaitelman, Simona F.; Tereffe, Welela; Dogan, Basak E.; Hess, Kenneth R.; Caudle, Abigail S.; Valero, Vicente; Stauder, Michael C.; Krishnamurthy, Savitri; Candelaria, Rosalind P.; Strom, Eric A.; Woodward, Wendy A.; Hunt, Kelly K.; Buchholz, Thomas A.; Whitman, Gary J.

In: International Journal of Radiation Oncology Biology Physics, Vol. 93, No. 1, 01.01.2015, p. 102-110.

Research output: Contribution to journalArticle

Shaitelman, Simona F. ; Tereffe, Welela ; Dogan, Basak E. ; Hess, Kenneth R. ; Caudle, Abigail S. ; Valero, Vicente ; Stauder, Michael C. ; Krishnamurthy, Savitri ; Candelaria, Rosalind P. ; Strom, Eric A. ; Woodward, Wendy A. ; Hunt, Kelly K. ; Buchholz, Thomas A. ; Whitman, Gary J. / Role of ultrasonography of regional nodal basins in staging triple-negative breast cancer and implications for Local-Regional Treatment Part of the findings herein were presented at the 56th Annual Meeting of the American Society of Radiation Oncology, San Francisco, CA, Sep 2014. In: International Journal of Radiation Oncology Biology Physics. 2015 ; Vol. 93, No. 1. pp. 102-110.
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abstract = "Purpose We sought to determine the rate at which regional nodal ultrasonography would increase the nodal disease stage in patients with triple-negative breast cancer (TNBC) beyond the clinical stage determined by physical examination and mammography alone, and significantly affect the treatments delivered to these patients. Methods and Materials We retrospectively reviewed the charts of women with stages I to III TNBC who underwent physical examination, mammography, breast and regional nodal ultrasonography with needle biopsy of abnormal nodes, and definitive local-regional treatment at our institution between 2004 and 2011. The stages of these patients' disease with and without ultrasonography of the regional nodal basins were compared using the Pearson χ2 test. Definitive treatments of patients whose nodal disease was upstaged on the basis of ultrasonographic findings were compared to those of patients whose disease stage remained the same. Results A total of 572 women met the study requirements. In 111 (19.4{\%}) of these patients, regional nodal ultrasonography with needle biopsy resulted in an increase in disease stage from the original stage by physical examination and mammography alone. Significantly higher percentages of patients whose nodal disease was upstaged by ultrasonographic findings compared to that in patients whose disease was not upstaged underwent neoadjuvant systemic therapy (91.9{\%} and 51.2{\%}, respectively; P<.0001), axillary lymph node dissection (99.1{\%} and 34.5{\%}, respectively; P<.0001), and radiation to the regional nodal basins (88.2{\%} and 29.1{\%}, respectively; P<.0001). Conclusions Regional nodal ultrasonography in TNBC frequently changes the initial clinical stage and plays an important role in treatment planning.",
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AU - Shaitelman, Simona F.

AU - Tereffe, Welela

AU - Dogan, Basak E.

AU - Hess, Kenneth R.

AU - Caudle, Abigail S.

AU - Valero, Vicente

AU - Stauder, Michael C.

AU - Krishnamurthy, Savitri

AU - Candelaria, Rosalind P.

AU - Strom, Eric A.

AU - Woodward, Wendy A.

AU - Hunt, Kelly K.

AU - Buchholz, Thomas A.

AU - Whitman, Gary J.

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N2 - Purpose We sought to determine the rate at which regional nodal ultrasonography would increase the nodal disease stage in patients with triple-negative breast cancer (TNBC) beyond the clinical stage determined by physical examination and mammography alone, and significantly affect the treatments delivered to these patients. Methods and Materials We retrospectively reviewed the charts of women with stages I to III TNBC who underwent physical examination, mammography, breast and regional nodal ultrasonography with needle biopsy of abnormal nodes, and definitive local-regional treatment at our institution between 2004 and 2011. The stages of these patients' disease with and without ultrasonography of the regional nodal basins were compared using the Pearson χ2 test. Definitive treatments of patients whose nodal disease was upstaged on the basis of ultrasonographic findings were compared to those of patients whose disease stage remained the same. Results A total of 572 women met the study requirements. In 111 (19.4%) of these patients, regional nodal ultrasonography with needle biopsy resulted in an increase in disease stage from the original stage by physical examination and mammography alone. Significantly higher percentages of patients whose nodal disease was upstaged by ultrasonographic findings compared to that in patients whose disease was not upstaged underwent neoadjuvant systemic therapy (91.9% and 51.2%, respectively; P<.0001), axillary lymph node dissection (99.1% and 34.5%, respectively; P<.0001), and radiation to the regional nodal basins (88.2% and 29.1%, respectively; P<.0001). Conclusions Regional nodal ultrasonography in TNBC frequently changes the initial clinical stage and plays an important role in treatment planning.

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