Evaluación clínica, ecográfica y citológica de la axila en el cáncer de mama

Abstract

ObjectiveTo evaluate the efficacy of axillary ultrasound and ultrasound-guided fine-needle aspiration cytology for the diagnosis of lymph node metastases in breast cancer. Material and methodsThis study included 340 consecutive patients with breast cancer. In all patients, the ipsolateral axilla was examined with ultrasound. Ultrasound-guided fine-needle aspiration cytology was performed in suspicious-looking lymph nodes. In all patients, the final pathologic result was obtained by sentinel node biopsy or axillary clearance. ResultsThe following values were obtained: sensitivity 80%, specificity 100%, positive predictive value 100%, negative predictive value 91%, false positives 0%, false negatives 9%.In patients with a clinically negative axilla and ultrasound-guided fine-needle aspiration cytology there were more than 2 metastatic lymph nodes in 63% of tumors measuring up to 20mm in diameter and in 83% of tumours larger than 20mm.In tumours measuring up to 20mm, there was only one metastatic lymph node in 92% of patients with a false negative result in the axillary ultrasound and in only 2 metastatic lymph nodes in 8%. ConclusionAxillary ultrasound and ultrasound-guided fine needle aspiration cytology have a high precision for axillary staging, offering useful information for treatment planning and allowing precise selection of breast cancer patients with a low tumour volume in the axilla.