3096: The clinical utility of sonographic evaluation of supraclavicular and internal mammary lymph node in patients with breast cancer

Abstract

Objectives: The purpose of this study was to evaluate the utility and efficacy of sonography for preoperative or pre-chemotherapeutic detection of supraclavicular and internal mammary lymph node metastases in patients with breast cancer. Methods: Preoperative or prechemotherapeutic sonography of both breasts, axillae, supraclavicular fossa and parasternal areas for lymph node metastasis were performed in consecutive 368 patients with primary breast cancer at our hospital between March 2003 and February 2004. Sonography-guided fine needle aspiration biopsy, excisional biopsy or thoracoscopic biopsy of enlarged supraclavicular and internal mammary lymph nodes was performed. Accuracy of sonographic findings compared with pathology was calculated. We reviewed follow-up of patients to confirm negativity of metastasis of lymph node on initial sonography. Results: On sonography, 17 of 383 patients had suspicious findings of metastatic supraclavicular lymph nodes. Incidence, sensitivity, specificity, accuracy, positive predictive value, negative predictive value were 4.1%, 93.8%, 99.5%, 99.2 %, 88.2% and 99.7%, respectively. Six patients had suspicious findings of metastatic internal mammary lymph nodes. Incidence, sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 1.8%, 71.4%, 99.7%, 83.3% and 99.5%, respectively. Conclusions: Sonographic evaluation of supraclavicular and internal mammary lymph nodes is accurate and useful study for predicting lymph node metastasis in patients with breast cancer.