UNASSIGNED: 1049 Background: The Katz nomogram is an established clinical-pathologic tool to identify @entity1 with a high likelihood of harboring >=  4 occult axillary lymph nodes after a positive sentinel lymph node biopsy. This study examines the ability of preoperative Dynamic Contrast Enhanced MRI ( @entity9243 -MRI) to predict which sentinel node positive @entity1 will ultimately have >=  4 total positive axillary lymph nodes upon completion axillary dissection and assesses whether DCE-MRI can add predictive value to the Katz nomogram. METHODS: Retrospective review of consecutive @entity1 (6/2005 - 12/2009) undergoing sentinel lymph node biopsy was conducted to identify those with invasive @entity0 , clinically negative axillae, preoperative @entity9243 -MRI and positive sentinel node biopsy. @entity1 who received preoperative chemotherapy or did not undergo axillary dissection were excluded. Clinical and pathologic factors, @entity75 size, and quantitative @entity75 @entity9243 -MRI kinetics, including initial peak enhancement, percent rapid enhancement, and percent washout were collected from clinical records and prospective databases. @entity9243 -MRI parameters with univariate significance (p < 0.05) to predict >=  4 axillary nodes were modeled with stepwise regression. RESULTS: 98 @entity1 with 99 positive @entity1600 (one synchronous bilateral case) met study criteria. Stepwise regression identified @entity9243 -MRI volume adjusted peak enhancement and total washout as significant independent predictors of >= 4 metastatic axillary lymph nodes. ROC curves demonstrated an AUC of 0.78 for the Katz nomogram, 0.78 for the @entity9243 -MRI multivariate model, and 0.85 for a combination of the Katz nomogram and @entity9243 -MRI. The combined model was significantly more predictive than the Katz nomogram alone (p = 0.007). CONCLUSIONS: @entity9243 -MRI @entity75 kinetics significantly improved the accuracy of the Katz clinical-pathologic nomogram to predict the presence of >=  4 axillary node @entity3 . With validation of these results, @entity9243 -MRI may help predict which sentinel lymph node positive @entity1 have more extensive occult regional adenopathy requiring further therapy.

Can preoperative dynamic contrast-enhanced breast MRI predict extensive occult axillary lymph node XXXX in @entity1 with positive sentinel node biopsy?

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast cancer'] @entity75 :: ('MESH:D001927', 'Disease') :: ['primary lesion'] @entity1600 :: ('MESH:D014388', 'Disease') :: ['sentinel lymph node biopsies'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases'] @entity9243 :: ('D010936', 'Chemical') :: ['DCE']
@entity3 :: (MESH:D009362,Disease) :: ['metastases']
