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KMID : 0848020030060020087
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Journal of Korean Breast Cancer Society
2003 Volume.6 No. 2 p.87 ~ p.94
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The Accuracy of the Physical Examination, Mammography, and Ultrasonography in thye Assessment of Tumor Size and Axillary Lymph Node Metastasis in Breast Cancer Patient
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이청숙/Lee CS
봉진구/박진현/이윤식/백선미/신미정/오훈규/정민희/이병철/Bong JG/Park JH/Lee YS/Paik SM/Shin MJ/Oh HK/Jeong MH/Lee BC
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Abstract
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Purpose : With the increasing use of neoadjuvant chemotherapy and minimally invasive therapy, the accuracy of preoperative determination of breast tumor size and axillary lymph node status become more important. The purpose of this study was to correlate physical examination, mammographic, and ultrasonographic measurements of tumor size and regional lymph mode status with pathologic findings and to evaluate the accuracy of various preoperative examination methods
Methods : Ninety patients presenting with palpable primary breast cancer treated with mastectomy or breast conserving surgery with axillary dissection were measured breast tumor size and axillary lymph node status by physical examination, mammography, and high resolution duplex ultrasonography, and correlated with the values obtained at pathologic examinations.
Reaults : The sensitivity of mammography and sonography for breast tumor were 82.5% and 90.8%, respectively. The average diameter of tumors was 3.39±1.77 cm on pathologic examination. Physical examination demonstrated the highest correlation coefficient (r=0.759) in measurement of the tumor size. The sensitivity of physical examination, mammography, and sonography for axillary node involvement were 37.5%, 57.7%, and 73.9%, respectively, and with specificity of 98.1%, 86.5%, and 92.9%, respectively, and with positive predictive value of 93.8%, 75.0%, and 85.0%, respectively.
Conclusion ; Physical examination is the best non-invasive predictor of the real size of palpable primary breast cancer, whereas high resolution duplex ultrasonography is most sensitive assessment method of axillary lymph node status. The specificity of axillary nodal status can be increased by fine-needle biopsy under sonographic guidance and it can be serve as useful adjuncts to sentinel node biopsy.
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KEYWORD
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