Imaging Protocol and Criteria for Evaluation of Axillary Lymph Nodes in the NAUTILUS Trial

• Published in: Journal of breast cancer Vol. 24; no. 6; pp. 554 - 560
• Main Authors: Chang, Jung Min, Shin, Hee Jung, Choi, Ji Soo, Shin, Sung Ui, Choi, Bo Hwa, Kim, Min Jung, Yoon, Jung Hyun, Chung, Jin, Kim, Tae Hee, Han, Boo-Kyung, Kim, Hak Hee, Moon, Woo Kyung
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Breast Cancer Society 01.12.2021; 한국유방암학회
• Subjects: Brief Communication; 일반외과학; Breast Neoplasms; Sentinel Lymph Node Biopsy; Ultrasonography
• ISSN: 1738-6756; 2092-9900
• DOI: 10.4048/jbc.2021.24.e47

Axillary ultrasonography (US) is the most commonly used imaging modality for nodal evaluation in patients with breast cancer. No Axillary Surgical Treatment in Clinically Lymph Node-Negative Patients after Ultrasonography (NAUTILUS) is a prospective, multicenter, randomized controlled trial investigating whether sentinel lymph node biopsy (SLNB) can be safely omitted in patients with clinically and sonographically node-negative T1-2 breast cancer treated with breast-conserving therapy. In this trial, a standardized imaging protocol and criteria were established for the evaluation of axillary lymph nodes. Women lacking palpable lymph nodes underwent axillary US to dismiss suspicious nodal involvement. Patients with a round hypoechoic node with effaced hilum or indistinct margins were excluded. Patients with T1 tumors and a single node with a cortical thickness ≥ 3 mm underwent US-guided biopsy. Finally, patients with negative axillary US findings were included. The NAUTILUS axillary US nodal assessment criteria facilitate the proper selection of candidates who can omit SLNB. Trial Registration: ClinicalTrials.gov Identifier: NCT04303715.