Diagnostic and Interventional Radiology
Breast Imaging - Original Article

Value of accurate diagnosis for metastatic supraclavicular lymph nodes in breast cancer: assessment with neck US, 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 2021; 27: 323-328
DOI: 10.5152/dir.2021.20190
Read: 677 Downloads: 107 Published: 19 June 2020

PURPOSE 
Neck ultrasonography (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
SCN metastases identified in neck US, CT, or PET/CT during follow-up visits of patients with breast cancer were 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 the same as that of PET/CT, while the sensitivity rates of US alone and CT alone were 87.5% and 83.3%, respectively. Accuracy was 99.8% in PET/CT alone and 98.1% in US + CT. The false-negative rate was 0.1% in US + PET/CT, while it was 0.2% in PET/CT and US + CT, 0.3% in US alone and 0.4% in CT alone.

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

You may cite this article as: Lee J, Park HY, Kim WW, et al. Value of accurate diagnosis for metastatic supraclavicular lymph nodes in breast cancer: Assessment with neck US, CT, and 18F-FDG PET/CT. Diagn Interv Radiol 2021; 27:323–328

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