Ultrasound- an Evaluation Tool for Assessment of Breast Tumour and Axillary Lymph Node Size

Abstract

Aims: The present study was taken up in carcinoma breast patients to evaluate clinical examination and Ultrasound in estimating the breast tumour size and axillary lymph node size taking histopathological examination as the gold standard. Material & Methods: The study carried out between December 2008 to June 2010 included thirty seven carcinoma breast patients. Ethics committee clearance obtained. Twenty four patients received neoadjuvant chemotherapy followed by surgery. 13 patients were taken up directly for surgery. Largest dimension of the primary tumour and axillary lymph nodes were assessed clinically, sonologically and histopathologically. Results were analyzed using paired-t test and Pearson correlation coefficient. Results: Clinical examination overestimated breast tumour size, while underestimated axillary lymph node size in majority of the patients. Sonological examination underestimated both breast tumour size and axillary lymph node size in majority of patients. There was strong correlation (r =.719, p=<.001) between clinical and histopathological breast tumour size, however for axillary lymph nodes the correlation was moderate (r=.536, p= .001). A moderate correlation (r=0.601; p=<.001) was observed between sonological and pathological breast tumour size, while strong correlation (r=.652, p <0.001) was found for axillary lymph nodes. For breast tumour, the difference between mean clinical and histopathological size was 0.01cm and statistically not significant (t=.064, p=.949). However, the difference between mean sonological and histopathological size for breast tumour was 1.10cm, and statistically highly significant (t=-3.93, p<.001). For axillary lymph nodes, the difference in mean size between clinical and histopathological assessment was 0.46 cm (p=0.007) as against mean difference of 0.48 cm between sonological and histopathological assessment (p=0.001). Conclusion: In the present study, for primary breast tumour size estimation clinical assessment was as good as histopathological examination, however, ultrasound was found to be inferior. Whereas for axillary lymph node size estimation both clinical assessment and ultrasound were indifferent .