Epiq 5 systems

AUS using EPIQ 5 systems with 12- to 18-MHz high-frequency linear array transducers (Philips Healthcare, Andover, MA, USA) was interpreted by fellowship-trained radiologists with 5 to more than 20 years of breast-imaging experience. Mid-treatment AUS imaging interpretation employed an empirical categorization of the lymph nodes: using a binary approach of normal versus abnormal based on the presence or absence of suspicious morphologic features that included loss of fatty hilum, thickened cortex (> 3 mm), round shape, and/or focal cortical lobulation [11 (link)–14 (link)]. The numbers of abnormal nodes on still images were captured in longitudinal and transverse views and were part of the electronic medical record. For each patient, the number of abnormal nodes was documented in a pictogram that accompanied the patient’s chart. In addition, an experienced breast radiologist (R.P.C.) independently reviewed each case to validate the number of abnormal nodes recorded.

Patients underwent imaging at the comprehensive cancer center and 1 regional imaging center. DM at both locations was performed using Hologic Selenia Dimensions mammography systems (Hologic Inc, Bedford, MA, USA). US was performed using EPIQ 5 systems with 12- to 18 MHz high-frequency linear array transducers (Philips Healthcare, Andover, MA, USA). MRI was performed before and following intravenous contrast administration using 3T MRI scanners (Signa HDxt; GE Medical Systems, Milwaukee, WI, USA and Magnetom Skyra; Siemens Medical Solutions, Erlangen, Germany) using a 16-channel dedicated breast coil.