0533: Breast Cancer Staging with Sonography

Abstract

This presentation will discuss the use of sonography for staging in breast cancer. This presentation will focus on staging the breasts and the regional (axillary, infraclavicular, supraclavicular, and internal mammary) lymph nodes. Staging intramammary lymph nodes will also be covered. Ultrasound has been shown to be useful in demonstrating bilateral, multicentric, and multifocal disease in the breasts that was not identified on mammography and/or clinical examination. Likewise, sonography has been shown to be helpful in demonstrating metastatic lymph nodes that were not identified on mammography and/or clinical examination. In addition to identifying additional foci of disease in the breasts and the regional lymph nodes, sonography plays a major role in guiding biopsies in order to document disseminated disease. Ultrasound-guided fine needle aspiration and core needle biopsy have been shown to be efficacious in sampling breast lesions and regional lymph nodes. A successful ultrasound-guided fine needle aspiration program is dependent on appropriate cytology support. If strong cytology support is not available, then core needle biopsy should be performed. In addition to guiding breast biopsies and biopsies of the regional lymph nodes, sonography plays an important role in guiding placement of marker clips (usually in breast lesions and rarely in lymph nodes). Accurate staging is important as appropriate staging leads to appropriate treatment and treatment sequencing with chemotherapy, radiation therapy, and surgery.