Navigation Links
Lymph node ultrasounds more accurate in obese breast cancer patients

ROCHESTER, Minn. Mayo Clinic research into whether ultrasounds to detect breast cancer in underarm lymph nodes are less effective in obese women has produced a surprising finding. Fat didn't obscure the images and ultrasounds showing no suspicious lymph nodes actually proved more accurate in overweight and obese patients than in women with a normal body mass index, the study found. The research is among several Mayo studies presented at the American Society of Breast Surgeons annual meeting April 30-May 4 in Las Vegas.

Researchers studied 1,331 breast cancer patients who received ultrasounds of their axillary lymph nodes, the lymph nodes in the armpits, to check for cancer before surgery. Of those patients, 36 percent were considered obese, with a body mass index of 30 or more. Body mass index is a formula that uses weight and height to estimate body fat. Of the other women studied, 33 percent were of normal weight and 31 percent were overweight but not obese.

Obesity can change lymph nodes, including the way they look in imaging studies, and make physical examination of underarm lymph nodes more challenging. The Mayo study found that higher body weight didn't muddy ultrasounds of the axillary lymph nodes in overweight or obese cancer patients, and that their ultrasounds had better specificity and accuracy than those of thinner women, meaning that when ultrasound showed no suspicious lymph nodes, it was likelier to be correct.

"I think we were surprised at these results," says senior author Tina Hieken, M.D., a breast cancer surgeon at Mayo Clinic. ``It should be very reassuring that regardless of the weight of the patient, axillary ultrasound is helpful."

Potential reasons for the findings, Dr. Hieken speculates: Soft fatty tissue can be compressed during ultrasounds, and physicians now have more experience in knowing what lymph nodes may look like in overweight and obese patients. In some thin patients, ultrasounds may not yield as much information because underarm lymph nodes can be so close to the surface, it may be difficult to get good images, she says.

Surgeons do not rely on ultrasound alone to determine whether or not breast cancer has spread; it is one of several sources of information used to guide treatment.

"For most patients with invasive breast cancer, if the axillary ultrasound is negative, we perform a sentinel lymph node biopsy at the time of the breast operation to make sure cancer has not spread. When the preoperative axillary ultrasound shows suspicious lymph nodes, we then do a fine-needle aspiration of the lymph nodes. If that shows cancer, we may discuss other strategies with the patient such as giving chemotherapy before surgery," Dr. Hieken says.

More research is planned, including looking at different techniques of lymph node ultrasound to improve accuracy and perhaps to avoid axillary lymph node surgery altogether in some breast cancer patients with small tumors and negative axillary ultrasounds, she says.

In other Mayo studies being presented at ASBS, researchers found:

  • Using a regional anesthetic technique called a paravertebral block in breast cancer patients undergoing mastectomies reduces the need for narcotic painkillers after surgery and also means less postoperative nausea. The preoperative paravertebral block was used in addition to general anesthesia in 232 patients studied; they used fewer opioid painkillers and had less need for anti-nausea medication after surgery than 294 patients in the study who had mastectomies without the regional anesthetic."From a patient standpoint, if they're not nauseated and their pain is well-controlled, their entire surgical experience is better," says senior author Judy Boughey, M.D., a Mayo Clinic breast surgeon.

  • The rates of bilateral mastectomy, in which breast cancer patients have both breasts removed at once, were higher at hospitals where women could immediately have breast reconstruction surgery. At hospitals that offered immediate breast reconstruction, roughly 25 percent of women who had mastectomies had both breasts removed, compared to about 5 percent at hospitals that didn't offer immediate breast reconstruction."The advantage of the immediate breast reconstruction is ultimately fewer operations on the patient," says Dr. Boughey, the senior author. Mayo Clinic offers immediate breast reconstruction after mastectomy; breast reconstruction begins and may even be completed in the same operation as the mastectomy.


Contact: Sharon Theimer
Mayo Clinic

Related medicine news :

1. Researchers creating designer lymph nodes based on Moffitts Total Cancer Care initiative
2. Protein may represent a switch to turn off B cell lymphoma
3. Researchers make promising discovery in pursuit of effective lymphoma treatments
4. New drug strategy attacks resistant leukemia and lymphoma
5. Elsevier, SVS announce 2013 launch of Journal of Vascular Surgery: Venous and Lymphatic Disorders
6. Mutations in JAK3 gene identified in subtype of lymphoma provide potential drug target
7. Limited Radiation May Help Some Kids With Lymphoma
8. Progress in quest to reduce use of radiation in treatment of pediatric Hodgkin lymphoma
9. New drug dramatically improves survival in Hodgkin lymphoma patients
10. Moffitt Cancer Center researchers find potential key to new treatment for mantle cell lymphoma
11. New research seeks to improve survival for myeloma and lymphoma patients
Post Your Comments:
(Date:10/13/2015)... ... October 13, 2015 , ... "My friend's son suffers from eczema, and ... cheeks," said an inventor from Platteville, Colo. "I came up with this kit as ... the UNTOUCHABLE to prevent a child from rubbing or scratching his or her face. ...
(Date:10/13/2015)... ... October 13, 2015 , ... ... platform, ENGAGE, at HIMSS’s Patient Engagement Summit . HealthAware is a technology ... innovative health programs and interventions via mobile devices that provide a framework for ...
(Date:10/13/2015)... , ... October 13, 2015 , ... ... solutions, announced today their sponsorship of the Microsoft Dynamics AXUG, GPUG and NAVUG ... Summit, GPUG Summit and NAVUG Summit are independent user conferences designed and led ...
(Date:10/13/2015)... ... 2015 , ... In an age where the cost of energy is rising, ... foot than in 2009. The Williamsport Regional Medical Center (WRMC) campus has grown 50 ... eight percent. , According to Facilities Management Administrative Director Dieter Reichmann, this is ...
(Date:10/13/2015)... ... 2015 , ... e-con Systems Inc., a leading embedded design services company specializing ... first RGB-IR pixel format camera with a USB 3.0 interface and e-CAM40_CUMI4682_MOD, ... UVC USB 3.0 cameras, is based on the 1/3-inch OV4682 - a 4-megapixel image ...
Breaking Medicine News(10 mins):
(Date:10/13/2015)... China Jo-Jo Drugstores, Inc. (NASDAQ ... a leading China-based retail, wholesale and online distributor of ... and retail pharmacies, announced preliminary half year fiscal 2016 ... through , growing 438% year over year, ... China Jo-Jo,s online sales are principally ...
(Date:10/13/2015)...  XiMo AG ( Lucerne , ... Milpitas, California ) announced today the launch ... importance of metathesis chemistry was highlighted by the Nobel ... application. This industrially-relevant application has been utilized in the ... chemicals, and polymers. Georg Fráter , COO ...
(Date:10/12/2015)... -- Apheresis is an invasive process that ... and other components from whole blood. In this procedure, the ... an apheresis machine or a blood cell separator. The apheresis ... other blood components. A selected part of the blood is ... or the patient. It involves the use of devices and ...
Breaking Medicine Technology: