caa a22 4500 445339144 CHVBK 20180317142806.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1245/s10434-011-1959-x doi (NATIONALLICENCE)springer-10.1245/s10434-011-1959-x Sensitivity of Axillary Specimen X-ray to Predict Nodal Count and Positivity [Elektronische Daten] [Chad Johnson, Soheila Korourian, Brian Badgwell, Robert Fincher, Carol Dell, C. Don Bice, Cristiano Boneti, Kent Westbrook, V. Klimberg] Background: The number of examined axillary lymph nodes (ALN) has been proposed as an indicator of prognosis along with quality and adequacy in breast cancer surgery. The purpose of this study was to examine the utility of imaging axillary specimens with x-ray (lymphogram) to determine the number of lymph nodes. We sought to determine the sensitivity and specificity of a lymphogram in identifying nodal positivity. Methods: Patients who underwent sentinel lymph node (SLN) and axillary lymph node dissections (ALND) were prospectively accrued to this double-blinded, single-institution trial from December 2009 to January 2011. A single physician interpreted all lymphograms for the number of ALNs and positivity determined by size, spiculations, irregularities, and calcifications. Results: Twenty female (age 50.8±14.3years) patients were accrued to the study. The lymphogram located more lymph nodes compared with pathology in 11 of 16 cases (68.8%). In these 11 cases, lymphogram identified 170 nodes and the pathologist located 132 (77.6%). Of the 16 ALND specimens, 6 were from patients naive to chemotherapy and averaged 13.8±6.6 nodes; 10 were from neoadjuvant chemotherapy patients and had an average number of 14.9±7.4 nodes. In neoadjuvant chemotherapy patients, sensitivity of the lymphogram to detect nodal positivity was 91.7% and specificity was 33.3%. Conclusions: This study demonstrated that lymphogram accurately identifies nodal count. This can be used for documentation of an adequate ALND for reimbursement. Furthermore, there may be potential value of lymphogram in intraoperative determination of nodal positivity. Society of Surgical Oncology, 2011 Johnson Chad Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences, Winthrop P. Rockefeller Cancer Institute, Little Rock, AR, USA aut Korourian Soheila Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA aut Badgwell Brian Division of Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences Winthrop P. Rockefeller Cancer Institute, Little Rock, AR, USA aut Fincher Robert Department of Radiology, University of Arkansas for Medical Sciences, Winthrop P. Rockefeller Cancer Institute, Little Rock, AR, USA aut Dell Carol Department of Radiology, University of Arkansas for Medical Sciences, Winthrop P. Rockefeller Cancer Institute, Little Rock, AR, USA aut Don Bice C. Department of Radiology, University of Arkansas for Medical Sciences, Winthrop P. Rockefeller Cancer Institute, Little Rock, AR, USA aut Boneti Cristiano Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences, Winthrop P. Rockefeller Cancer Institute, Little Rock, AR, USA aut Westbrook Kent Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences, Winthrop P. Rockefeller Cancer Institute, Little Rock, AR, USA aut Klimberg V. Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences, Winthrop P. Rockefeller Cancer Institute, Little Rock, AR, USA aut Annals of Surgical Oncology Springer-Verlag 18/11(2011-10-01), 3181-3186 1068-9265 18:11<3181 2011 18 10434 https://doi.org/10.1245/s10434-011-1959-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1959-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Johnson Chad Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences, Winthrop P. Rockefeller Cancer Institute, Little Rock, AR, USA aut NATIONALLICENCE 700 1- Korourian Soheila Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA aut NATIONALLICENCE 700 1- Badgwell Brian Division of Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences Winthrop P. Rockefeller Cancer Institute, Little Rock, AR, USA aut NATIONALLICENCE 700 1- Fincher Robert Department of Radiology, University of Arkansas for Medical Sciences, Winthrop P. Rockefeller Cancer Institute, Little Rock, AR, USA aut NATIONALLICENCE 700 1- Dell Carol Department of Radiology, University of Arkansas for Medical Sciences, Winthrop P. Rockefeller Cancer Institute, Little Rock, AR, USA aut NATIONALLICENCE 700 1- Don Bice C. Department of Radiology, University of Arkansas for Medical Sciences, Winthrop P. Rockefeller Cancer Institute, Little Rock, AR, USA aut NATIONALLICENCE 700 1- Boneti Cristiano Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences, Winthrop P. Rockefeller Cancer Institute, Little Rock, AR, USA aut NATIONALLICENCE 700 1- Westbrook Kent Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences, Winthrop P. Rockefeller Cancer Institute, Little Rock, AR, USA aut NATIONALLICENCE 700 1- Klimberg V. Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences, Winthrop P. Rockefeller Cancer Institute, Little Rock, AR, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/11(2011-10-01), 3181-3186 1068-9265 18:11<3181 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer