Correlation of the use of axillary ultrasound and lymph node needle biopsy with surgical lymph node pathology in patients with invasive breast cancer.
BACKGROUND
Results vary regarding the utility of perioperative axillary ultrasound (AUS) and biopsy for detecting axillary metastases.


METHODS
Patients diagnosed with invasive breast cancer from 2004 through 2005 who underwent preoperative AUS with or without biopsy, and their surgical pathologic findings were reviewed.


RESULTS
Of 152 patients who underwent preoperative AUS, 38% had abnormal AUS findings. Sixty-two percent of biopsy specimens were positive. The sensitivity of AUS both with and without biopsy was 54%, and specificity was 96%. The positive predictive value was 91%, and the negative predictive value was 71%.


CONCLUSIONS
Our results correlate favorably with published reports of preoperative AUS. Standardization of AUS report descriptors is needed. Preoperative AUS should be included in the preoperative workup of clinically node-negative patients. A positive biopsy specimen decreases the need for a sentinel lymph node biopsy specimen; however, a negative AUS result or biopsy specimen does not replace the need to obtain a sentinel lymph node biopsy specimen.
Department of Surgery, Allegheny General Hospital, Pittsburgh, PA, USA.
Michael S
MS
Cowher
Kathleen M
KM
Erb
William
W
Poller
Thomas B
TB
Julian
D001365:Axilla / Q000000981:diagnostic imaging*; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D012042:Registries; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary