Diagnostic and Interventional Radiology
Breast Imaging - Original Article

Value of accurate diagnosis for metastatic supraclavicular lymph nodes in breast cancer: Assessment with neck ultrasound, CT, and 18F-FDG PET/CT

1.

Department of Surgery, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea

2.

Department of Radiology, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea

3.

Department of Nuclear Medicine, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea

4.

Department of Hemato-Oncology, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea

5.

Department of Pathology, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea

Diagn Interv Radiol 2020; 1: -
Read: 133 Published: 19 June 2020

PURPOSE: Neck ultrasound (US), computed tomography (CT), and 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) are all known to be useful imaging modalities for detecting supraclavicular lymph node (SCN) metastasis in breast cancer. The authors compared the diagnostic values of neck US, CT, and PET/CT in the detection of SCN metastasis in breast cancer.

METHODS: When an SCN metastasis was identified in neck US, CT, or PET/CT during follow-up visits of patients with breast cancer, it was pathologically confirmed with the use of US-guided fine-needle aspiration cytology. The clinicopathological factors of the patients were analyzed, and the statistical parameters including sensitivity, specificity, positive and negative predictive values, false-positive and false-negative rates, and accuracy of neck US, CT, and PET/CT were compared.

RESULTS: Among 32 cases of suspicious SCNs, 24 were pathologically confirmed as metastasis of breast cancer. The sensitivity of US + CT was 91.7% which was same as that of PET/CT and that of US alone, CT alone was 87.5% and 83.3%, respectively. Accuracy was 99.8% in PET/CT alone and 98.1% in US + CT. However, the false-negative rate in US + PET/CT was 0.1%, while in PET/CT and US + CT was 0.2% and in US alone and CT alone was 0.3% and 0.4%, respectively.

CONCLUSION: PET/CT can be considerable for detecting SCN metastases in breast cancer. However, if PET/CT is unavailable for any reason, US + CT could be the second option to avoid false-negative results.

EISSN 1305-3612