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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Incidence of Internal Mammary Lymph Nodes with Silicone Breast Implants at MR Imaging after Oncoplastic Surgery</title><author><name sortKey="Sutton, Elizabeth J" sort="Sutton, Elizabeth J" uniqKey="Sutton E" first="Elizabeth J." last="Sutton">Elizabeth J. Sutton</name></author><author><name sortKey="Watson, Elizabeth J" sort="Watson, Elizabeth J" uniqKey="Watson E" first="Elizabeth J." last="Watson">Elizabeth J. Watson</name></author><author><name sortKey="Gibbons, Girard" sort="Gibbons, Girard" uniqKey="Gibbons G" first="Girard" last="Gibbons">Girard Gibbons</name></author><author><name sortKey="Goldman, Debra A" sort="Goldman, Debra A" uniqKey="Goldman D" first="Debra A." last="Goldman">Debra A. Goldman</name></author><author><name sortKey="Moskowitz, Chaya S" sort="Moskowitz, Chaya S" uniqKey="Moskowitz C" first="Chaya S." last="Moskowitz">Chaya S. Moskowitz</name></author><author><name sortKey="Jochelson, Maxine S" sort="Jochelson, Maxine S" uniqKey="Jochelson M" first="Maxine S." last="Jochelson">Maxine S. Jochelson</name></author><author><name sortKey="Dershaw, D David" sort="Dershaw, D David" uniqKey="Dershaw D" first="D. David" last="Dershaw">D. David Dershaw</name></author><author><name sortKey="Morris, Elizabeth A" sort="Morris, Elizabeth A" uniqKey="Morris E" first="Elizabeth A." last="Morris">Elizabeth A. Morris</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26098457</idno><idno type="pmc">4976465</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976465</idno><idno type="RBID">PMC:4976465</idno><idno type="doi">10.1148/radiol.2015142717</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">003183</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">003183</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Incidence of Internal Mammary Lymph Nodes with Silicone Breast Implants at MR Imaging after Oncoplastic Surgery</title><author><name sortKey="Sutton, Elizabeth J" sort="Sutton, Elizabeth J" uniqKey="Sutton E" first="Elizabeth J." last="Sutton">Elizabeth J. Sutton</name></author><author><name sortKey="Watson, Elizabeth J" sort="Watson, Elizabeth J" uniqKey="Watson E" first="Elizabeth J." last="Watson">Elizabeth J. Watson</name></author><author><name sortKey="Gibbons, Girard" sort="Gibbons, Girard" uniqKey="Gibbons G" first="Girard" last="Gibbons">Girard Gibbons</name></author><author><name sortKey="Goldman, Debra A" sort="Goldman, Debra A" uniqKey="Goldman D" first="Debra A." last="Goldman">Debra A. Goldman</name></author><author><name sortKey="Moskowitz, Chaya S" sort="Moskowitz, Chaya S" uniqKey="Moskowitz C" first="Chaya S." last="Moskowitz">Chaya S. Moskowitz</name></author><author><name sortKey="Jochelson, Maxine S" sort="Jochelson, Maxine S" uniqKey="Jochelson M" first="Maxine S." last="Jochelson">Maxine S. Jochelson</name></author><author><name sortKey="Dershaw, D David" sort="Dershaw, D David" uniqKey="Dershaw D" first="D. David" last="Dershaw">D. David Dershaw</name></author><author><name sortKey="Morris, Elizabeth A" sort="Morris, Elizabeth A" uniqKey="Morris E" first="Elizabeth A." last="Morris">Elizabeth A. Morris</name></author></analytic><series><title level="j">Radiology</title><idno type="ISSN">0033-8419</idno><idno type="eISSN">1527-1315</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Internal mammary lymph nodes are commonly seen at implant-protocol breast MR imaging; the interpreting radiologist should be aware of this finding because the likelihood that it represents metastatic disease is extremely low, suggesting that imaging follow-up would be more appropriate than full oncologic work-up.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Radiology</journal-id><journal-id journal-id-type="iso-abbrev">Radiology</journal-id><journal-id journal-id-type="publisher-id">Radiology</journal-id><journal-title-group><journal-title>Radiology</journal-title></journal-title-group><issn pub-type="ppub">0033-8419</issn><issn pub-type="epub">1527-1315</issn><publisher><publisher-name>Radiological Society of North America</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26098457</article-id><article-id pub-id-type="pmc">4976465</article-id><article-id pub-id-type="publisher-manuscript">142717</article-id><article-id pub-id-type="doi">10.1148/radiol.2015142717</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Research</subject><subj-group><subject>Breast Imaging</subject></subj-group></subj-group><subj-group subj-group-type="subject"><compound-subject><compound-subject-part content-type="code">BR</compound-subject-part><compound-subject-part content-type="text">Breast Imaging</compound-subject-part></compound-subject><compound-subject><compound-subject-part content-type="code">MR</compound-subject-part><compound-subject-part content-type="text">Magnetic Resonance Imaging</compound-subject-part></compound-subject></subj-group></article-categories><title-group><article-title>Incidence of Internal Mammary Lymph Nodes with Silicone Breast Implants at MR Imaging after Oncoplastic Surgery</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Sutton</surname><given-names>Elizabeth J.</given-names></name><degrees>MD</degrees><email xlink:href="suttone@mkscc.org">suttone@mkscc.org</email></contrib><contrib contrib-type="author"><name><surname>Watson</surname><given-names>Elizabeth J.</given-names></name><degrees>MD</degrees><xref ref-type="fn" rid="fn1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Gibbons</surname><given-names>Girard</given-names></name><degrees>BA</degrees></contrib><contrib contrib-type="author"><name><surname>Goldman</surname><given-names>Debra A.</given-names></name><degrees>MS</degrees></contrib><contrib contrib-type="author"><name><surname>Moskowitz</surname><given-names>Chaya S.</given-names></name><degrees>PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Jochelson</surname><given-names>Maxine S.</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Dershaw</surname><given-names>D. David</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Morris</surname><given-names>Elizabeth A.</given-names></name><degrees>MD</degrees></contrib><aff id="aff1">From the Department of Radiology (E.J.S., E.J.W., G.G., M.S.J., D.D.D., E.A.M.) and Department of Epidemiology & Biostatistics (D.A.G., C.S.M.), Memorial Sloan-Kettering Cancer Center, 300 E 66th St, Suite 715, New York, NY 10065.</aff></contrib-group><author-notes><corresp id="cor1"><bold>Address correspondence to</bold> E.J.S. (e-mail: <italic><email xlink:href="suttone@mkscc.org">suttone@mkscc.org</email></italic>).</corresp><fn fn-type="con"><p><bold>Author contributions:</bold> Guarantors of integrity of entire study, E.J.S., G.G.; study concepts/study design or data acquisition or data analysis/interpretation, all authors; manuscript drafting or manuscript revision for important intellectual content, all authors; approval of final version of submitted manuscript, all authors; agrees to ensure any questions related to the work are appropriately resolved, all authors; literature research, E.J.S., E.J.W., G.G.; clinical studies, E.J.S., G.G., M.S.J., D.D.D., E.A.M.; statistical analysis, D.A.G., C.S.M.; and manuscript editing, E.J.S., E.J.W., G.G., D.A.G., M.S.J., D.D.D., E.A.M.</p></fn></author-notes><pub-date pub-type="ppub"><month>11</month><year>2015</year><string-date>November 2015</string-date></pub-date><pub-date pub-type="epub"><day>18</day><month>6</month><year>2015</year></pub-date><volume>277</volume><issue>2</issue><fpage>381</fpage><lpage>387</lpage><permissions><copyright-statement>2015 by the Radiological Society of North America, Inc.</copyright-statement><copyright-year>2015</copyright-year></permissions><self-uri content-type="pdf" xlink:href="radiol.2015142717.pdf"></self-uri><abstract abstract-type="synopsis"><p>Internal mammary lymph nodes are commonly seen at implant-protocol breast MR imaging; the interpreting radiologist should be aware of this finding because the likelihood that it represents metastatic disease is extremely low, suggesting that imaging follow-up would be more appropriate than full oncologic work-up.</p></abstract><abstract><sec><title>Purpose</title><p>To assess the incidence of benign and malignant internal mammary lymph nodes (IMLNs) at magnetic resonance (MR) imaging among women with a history of treated breast cancer and silicone implant reconstruction.</p></sec><sec><title>Materials and Methods</title><p>The institutional review board approved this HIPAA-compliant retrospective study and waived informed consent. Women were identified who <italic>(a)</italic> had breast cancer, <italic>(b)</italic> underwent silicone implant oncoplastic surgery, and <italic>(c)</italic> underwent postoperative implant-protocol MR imaging with or without positron emission tomography (PET)/computed tomography (CT) between 2000 and 2013. The largest IMLNs were measured. A benign IMLN was pathologically proven or defined as showing 1 year of imaging stability and/or no clinical evidence of disease. Malignant IMLNs were pathologically proven. Incidence of IMLN and positive predictive value (PPV) were calculated on a per-patient level by using proportions and exact 95% confidence intervals (CIs). The Wilcoxon rank sum test was used to assess the difference in axis size.</p></sec><sec><title>Results</title><p>In total, 923 women with breast cancer and silicone implants were included (median age, 46 years; range, 22–89 years). The median time between reconstructive surgery and first MR imaging examination was 49 months (range, 5–513 months). Of the 923 women, 347 (37.6%) had IMLNs at MR imaging. Median short- and long-axis measurements were 0.40 cm (range, 0.20–1.70 cm) and 0.70 cm (range, 0.30–1.90 cm), respectively. Two hundred seven of 923 patients (22.4%) had adequate follow-up; only one of the 207 IMLNs was malignant, with a PPV of 0.005 (95% CI: 0.000, 0.027). Fifty-eight of 923 patients (6.3%) had undergone PET/CT; of these, 39 (67.2%) had IMLN at MR imaging. Twelve of the 58 patients (20.7%) with adequate follow-up had fluorine 18 fluorodeoxyglucose–avid IMLN, with a median standardized uptake value of 2.30 (range, 1.20–6.10). Only one of the 12 of the fluorodeoxyglucose-avid IMLNs was malignant, with a PPV of 0.083 (95% CI: 0.002, 0.385).</p></sec><sec><title>Conclusion</title><p>IMLNs identified at implant-protocol breast MR imaging after oncoplastic surgery for breast cancer are overwhelmingly more likely to be benign than malignant. Imaging follow-up instead of immediate metastatic work-up may be warranted.</p><p><sup>©</sup> RSNA, 2015</p></sec></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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