Axillary ultrasonography for early-stage invasive breast cancer

Abstract

BackgroundAmong women with early invasive breast cancer and 1–2 positive sentinel nodes, sentinel lymph node biopsy (SLNB) is non-inferior to axillary lymph node dissection (ALND).1-3 However, preoperative axillary ultrasonography (AxUS) may not be sensitive enough to discriminate burden of nodal metastasis in these patients, potentially leading to overtreatment.4-6 This study compares axillary operation rates in patients who did and did not receive preoperative AxUS, assessing its utility and risks for overtreatment. MethodsThis is a retrospective cohort study of patients with clinical T1/T2 breast tumors who were clinically node negative and underwent an axillary operation. ResultsPatients who had preoperative AxUS received more ALND compared to patients who did not (5.6% vs. 1.4%, p ​< ​0.001). There was no significant difference in the number of additional axillary operations following SLNB (2.1% vs. 2.3%, p ​= ​0.77). ConclusionEliminating preoperative AxUS is associated with fewer invasive ALND procedures, without increased rate of axillary reoperations.