The Accuracy of Preoperative Axillary Ultrasound in the Diagnosis of Lymph Node Involvement at Motamed Cancer Institute, Iran

Abstract

Background: Axillary lymph node (LN) status plays an important role in the local and systemic treatment of patients with breast cancer. Preoperative axillary ultrasound (AUS) is routinely used for the evaluation of axillary lymph nodes as a non-invasive method. Objectives: The purpose of this study was to evaluate the sensitivity and specificity of axillary ultrasound in comparison with pathology in a referral breast center. Methods: During a cross-sectional study all patients with breast cancer presenting to the imaging department between September 2015 and August 2016 were evaluated for axillary lymph node status by ultrasound. After comparing these results with the pathology of LNs, the sensitivity, specificity, and accuracy of the ultrasound in the diagnosis of axillary lymph node involvement were measured. Results: Overall 140 patients were enrolled in the study. The mean age of patients was 48.87 (± 10.46) years with an age range between 25 - 81 years. The sensitivity, specificity, and accuracy of the ultrasound were reported as 56%, 88%, and 76%, respectively. The highest sensitivity rate was related to AUS + Physical examination (PE) with 70%. The best specificity was for AUS, about 88%, and the accuracy of AUS+PE was the highest about 80%. Conclusions: The sensitivity of the AUS in the diagnosis of axillary involvement in the Motamed Cancer Institute was moderate and the specificity was good. The combination of physical examination and ultrasound could improve the sensitivity in comparison to each one alone. If both are suspicious, axillary dissection could be considered when fine needle aspiration (FNA) or core needle biopsy (CNB) of the lymph node is not available.