Preoperative axillary ultrasonography in patients with breast cancer: a prospective study to evaluate its ability to predict axillary tumor load.

OBJECTIVE: This study aimed to determine the ability of axillary ultrasonography to predict the number of lymph nodes with metastases found in sentinel node axillary surgery or axillary lymph node resection in patients recently diagnosed with breast cancer after percutaneous biopsy. METHODS: This prospective study included patients diagnosed with invasive breast cancer by percutaneous biopsy. Axillary lymph nodes were classified at ultrasound examination as suspicious or not suspicious, and the number of suspicious nodes was compared with the number classified as suspicious in the surgical specimen. RESULTS: We included 142 patients, 4 of whom had bilateral cancer; 133 of the 146 tumors were clinically classified as T1-T2 N0. The median number of suspicious lymph nodes at ultrasound was 2 (1-6), and the median number of suspicious lymph nodes in the surgical biopsy specimen was 1 (1-16); the difference was not significant (p = 0.1). The correlation between the number of positive lymph nodes on axillary ultrasound and the number of metastatic lymph nodes in the surgical specimen was 72.7% p = 0.0002 and the concordance was 79% (95%CI 62.4%-95.6%) p = 0.0001. For diagnosing high axillary tumor load (≥3 metastatic lymph nodes) versus low axillary tumor load (<3 metastatic lymph nodes), axillary ultrasound had 86.6% sensitivity, 83.3% specificity, 92% PPV, and 71.4% NPV. CONCLUSION: Our results show that preoperative axillary ultrasound can differentiate between low and high tumor load and can be used as a tool to select the type of treatment. These results need to be confirmed in randomized multicenter studies.

Spanish-language cognitive screening tests: a critical review.

INTRODUCTION: Dementia is a chronic, degenerative disease with a strong impact on families and health systems. The instruments currently in use for measuring cognitive impairment have different psychometric characteristics in terms of application time, cut-off point, reliability, and validity. The objective of this review is to describe the characteristics of the validated, Spanish-language versions of the Mini-Cog, Clock-Drawing Test, and Mini-Mental State Examination scales for cognitive impairment screening. DEVELOPMENT: We performed a three-stage literature search of articles published on Medline since 1953. We selected articles on validated, Spanish-language versions of the scales that included data on reliability, validity, sensitivity, and specificity. CONCLUSIONS: The 3 screening tools assessed in this article provide support for primary care professionals. Timely identification of mild cognitive impairment and dementia is crucial for the prognosis of these patients.

Escalas de tamizaje cognitivo en habla hispana: una revisión crítica / Spanish-language screening scales: A critical review

Introducción: La demencia es una enfermedad crónica degenerativa de alto impacto para las familias y los sistemas de salud. Los instrumentos de medición del deterioro cognitivo que se utilizan actualmente tienen características psicométricas diferentes en cuanto a tiempo de aplicación, punto de corte, confiabilidad y validez. El objetivo de la presente revisión fue describir las características de las escalas Mini Cog, Prueba del reloj y Mini- Mental para tamizaje de deterioro cognitivo validadas al idioma español. Desarrollo: La búsqueda bibliográfica se realizó en 3 etapas mediante la base de datos Medline a partir del año 1953. Se realizó una selección de publicaciones validadas al español que incluyeran la confiabilidad, validez, sensibilidad y especificidad de las escalas. Conclusiones: Las 3 herramientas de tamizaje descritas en este artículo proporcionan un apoyo para el personal de salud. La detección oportuna es crucial para el pronóstico de las personas que viven con deterioro cognitivo leve o demencia. (AU)

Introduction: Dementia is a chronic, degenerative disease with a strong impact on families and health systems. The instruments currently in use for measuring cognitive impairment have different psychometric characteristics in terms of application time, cut-off point, reliability, and validity. The objective of this review is to describe the characteristics of the validated, Spanish-language versions of the Mini-Cog, Clock-Drawing Test, and Mini–Mental State Examination scales for cognitive impairment screening. Development: We performed a three-stage literature search of articles published on Medline since 1953. We selected articles on validated, Spanish-language versions of the scales that included data on reliability, validity, sensitivity, and specificity. Conclusions: The 3 screening tools assessed in this article provide support for primary care professionals. Timely identification of mild cognitive impairment and dementia is crucial for the prognosis of these patients. (AU)

Preoperative axillary ultrasonography in patients with breast cancer: a prospective study to evaluate its ability to predict axillary tumor load. / Ecografía axilar prequirúrgica en pacientes con cáncer de mama. Estudio prospectivo para valorar la capacidad de predecir la carga tumoral axilar.

OBJECTIVE: This study aimed to determine the ability of axillary ultrasonography to predict the number of lymph nodes with metastases found in sentinel node axillary surgery or axillary lymph node resection in patients recently diagnosed with breast cancer after percutaneous biopsy. METHODS: This prospective study included patients diagnosed with invasive breast cancer by percutaneous biopsy. Axillary lymph nodes were classified at ultrasound examination as suspicious or not suspicious, and the number of suspicious nodes was compared with the number classified as suspicious in the surgical specimen. RESULTS: We included 142 patients, 4 of whom had bilateral cancer; 133 of the 146 tumors were clinically classified as T1-T2 N0. The median number of suspicious lymph nodes at ultrasound was 2 (1-6), and the median number of suspicious lymph nodes in the surgical biopsy specimen was 1 (1-16); the difference was not significant (p=0.1). The correlation between the number of positive lymph nodes on axillary ultrasound and the number of metastatic lymph nodes in the surgical specimen was 72.7% p=0.0002 and the concordance was 79% (95%CI 62.4%-95.6%) p=0.0001. For diagnosing high axillary tumor load (≥3 metastatic lymph nodes) versus low axillary tumor load (<3 metastatic lymph nodes), axillary ultrasound had 86.6% sensitivity, 83.3% specificity, 92% PPV, and 71.4% NPV. CONCLUSION: Our results show that preoperative axillary ultrasound can differentiate between low and high tumor load and can be used as a tool to select the type of treatment. These results need to be confirmed in randomized multicenter studies.

Spanish-language screening scales: A critical review. / Escalas de tamizaje cognitivo en habla hispana: una revisión crítica.

INTRODUCTION: Dementia is a chronic, degenerative disease with a strong impact on families and health systems. The instruments currently in use for measuring cognitive impairment have different psychometric characteristics in terms of application time, cut-off point, reliability, and validity. The objective of this review is to describe the characteristics of the validated, Spanish-language versions of the Mini-Cog, Clock-Drawing Test, and Mini-Mental State Examination scales for cognitive impairment screening. DEVELOPMENT: We performed a three-stage literature search of articles published on Medline since 1953. We selected articles on validated, Spanish-language versions of the scales that included data on reliability, validity, sensitivity, and specificity. CONCLUSIONS: The 3 screening tools assessed in this article provide support for primary care professionals. Timely identification of mild cognitive impairment and dementia is crucial for the prognosis of these patients.