The clinical value of preoperative axillary contrast-enhanced ultrasonography combined with core-needle biopsy to the assessment of axillary lymph node status in breast cancer

Abstract

Objective Preoperative axillary normal ultrasound and contrast-enhanced ultrasonography (CEUS) combined with core-needle biopsy (CNB) guided by ultrasonography were used to analyze the axillary lymph node status in breast cancer, and the clinical value to axillary operation is discussed. Methods The axillary lymph node status of 98 patients with breast cancer was analyzed by normal ultrasound and CEUS. Forty-one abnormal cases out of 98 patients were subjected to axillary lymph node core-needle biopsy guided by ultrasonography. The sentinel lymph node biopsy (SLNB) or sentinel lymph node dissection (ALND) was performed on all patients. A comparison between normal ultrasound, CEUS and postoperative pathological results was made, and a comparison between core-needle biopsy results and postoperative pathological results was also made. Results Thirty-seven out of 98 patients were diagnosed as having axillary lymph node metastasis postoperatively. The sensitivity, specificity, accuracy of normal ultrasound and CEUS to the assessment of axillary lymph node status were 86.49%, 63.93%, 72.45%, and 81.08%, 91.80%, 87.76% respectively. The sensitivity of the two methods showed no statistically insignificant (P=0.528), but the specificity and accuracy of the two methods had statistically significant (P=0.000, P=0.007). In addition, the sensitivity, specificity and accuracy of axillary lymph node core-needle biopsy guided by ultrasonography were 86.67%, 100% and 90.24% respectively. Conclusion CEUS combined with CNB can improve the specificity and accuracy in the assessment of axillary lymph node status in breast cancer and has a high clinical value to axillary operation. Key words: Breast cancer; Axillary lymph node; Contrast-enhanced ultrasonography; Needle biopsy