Evolving imaging techniques for staging axillary lymph nodes in breast cancer

Area of Science:

• Oncology
• Radiology
• Surgical Pathology

Background:

• Axillary nodal status is critical for breast cancer prognosis and treatment decisions.
• Axillary staging has evolved from axillary lymph node dissection (ALND) to sentinel lymph node biopsy (SLNB).
• Radiological staging, particularly ultrasound, is increasingly important for axillary assessment.

Purpose of the Study:

• To review the evolution and current role of axillary staging in breast cancer.
• To highlight the utility and limitations of preoperative axillary ultrasound.
• To explore emerging ultrasound techniques for improved axillary nodal evaluation.

Main Methods:

• Review of axillary staging techniques in breast cancer management.
• Discussion of grey-scale ultrasound and its role in nodal assessment.
• Exploration of advanced ultrasound modalities like elastography and microbubble contrast agents.

Main Results:

• Grey-scale ultrasound is widely used but has limitations in accuracy.
• Elastography may improve differentiation between benign and malignant nodes.
• Ultrasound-guided techniques with microbubbles show potential for non-surgical sentinel lymph node biopsy.

Conclusions:

• Accurate axillary staging is essential for breast cancer patient management.
• Advanced ultrasound techniques offer improved diagnostic capabilities for axillary nodes.
• Novel ultrasound-guided methods may reduce the need for surgical sentinel lymph node biopsy in selected patients.