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Dynamic enhanced computed tomography values of locally advanced breast cancers predicting axilla nodal metastasis after neoadjuvant chemotherapy
Journal of Computer Assisted Tomography, 06/16/09

Cheung YC et al. - In a study to investigate the differences of dynamic enhanced values between locally advanced breast cancers with and without axillary nodal metastasis on computed tomography (CT) after neoadjuvant chemotherapy, additional information of dynamic CT reveals statistically distinguishable net maximal enhancement (NME) between those advanced breast cancers with or without axilla nodal metastasis after chemotherapy.

Methods

Pts with locally advanced breast cancer (greatest diameter >5 cm before chemotherapy) who completed preoperative neoadjuvant chemotherapy and ready to undertake subsequent surgery received dynamic CT.
CT enhancement values were measured on the main breast cancers in the greatest diameter.
Means of enhancement were compared between the categories with nonmetastasized and metastasized nodal axilla.

Results

39 pts with locally advanced breast cancers, 15 pts without, and 24 with metastasized nodal axilla, were enrolled.
Pts with metastasized axilla nodes had significantly higher NME than that of pts without metastasis.
Using the receiver operating characteristic curve, the cutoff NME in differentiating the nonmetastasized and metastasized axilla nodal status was optimally chosen at 40 Hounsfield, with sensitivity of 88.24%, specificity of 50%, positive predictive value of 71.4%, negative predictive value of 75%, and accuracy of 72.4% after chemotherapy.

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