title: Utility of axillary ultrasound examination to select breast cancer patients suited for optimal sentinel node biopsy.
abstract: BACKGROUND
  Because sentinel node (SN) biopsy (SNB) is known to produce false-negative results, we examined the usefulness of axillary ultrasound (AUS) in selecting patients suitable for optimal SNB.
  
  
  METHODS
  A positive AUS finding (positive AUS) was defined as an echo pattern of a homogeneously hypoechoic SN without an echo-rich center, indicating massive to extensive nodal involvement. The identification of SNs was performed, and complete axillary dissection was carried out.
  
  
  RESULTS
  A total of 262 women were enrolled into the study (T1 disease = 94; T2 disease = 145; and T3 disease = 23). The incidence of positive AUS increased with increasing size of breast tumor (P <0.0001). The overall identification and false-negative rates were 88.2% and 10.8%, respectively. However, when limited to AUS-negative patients, SNs were identified in 205 of 208 patients (98.6%), and the false-negative rate was 1.7%.
  
  
  CONCLUSIONS
  AUS should be included in the preoperative procedure for the selection of breast cancer patients suitable for SNB.
authors.affiliation: Department of Surgery I, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan. sato-k-a@mtg.biglobe.ne.jp
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Sato
authors.forename: Kuniyoshi
authors.initials: K
authors.lastname: Tamaki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tsuda
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kosuda
authors.forename: Shoichi
authors.initials: S
authors.lastname: Kusano
authors.forename: Hoshio
authors.initials: H
authors.lastname: Hiraide
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Mochizuki
mesh_terms: D001365:Axilla / Q000000981:diagnostic imaging*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy; D014463:Ultrasonography