[Role of ultrasonography in the diagnosis of axillary lymph node metastases in breast cancer: a systematic review].
Axillary lymph nodes metastases are an important prognostic factor in patient with breast cancer. Even the diagnosis of metastatic invasion of axilla is perfomed by histologic exam, the preoperative diagnosis on ultrasonography is evoked in literature. The aim of this study was to evaluate through systematic review, the accuracy of ultrasonography in the diagnosis of axillary lymph node invasion in patients with breast cancer. 132 articles were consulted. We included in the study articles in which the invasion of axilla was proved by histology and additionally, studies in which sensibility, specificity and accuracy parameters of ultrasonography can be calculated. The Chi square test was used to evaluate the hetegenicity between studies. Twelve articles with above criteria were included in the study and divided in two groups: group 1: studies on breast cancer with palpable and non palpable axillary lymph node; group 2 : studies on breast cancer in which axillary lymph node biopsy was guided by ultrasonography. In group I, when lymph node size, more than 5 mm was taken as presumption criteria of invasion, sensibility and specificity of ultrasonography varied from 66.1 to 87.1% (p > 0.05) and from 44.1 to 97.9% (p < 0.05) respectively; when the lymph node morphology was the mean criteria of axilla invasion, these parameters varied respectively from 40.5 to 92.3% (p < 0.05) and from 55.6 to 95.2% (p < 0.05). In group II, sensibility and specificity of ultrasonography in diagnosis presumption of axillary lymph node invasion in patient with breast cancer varied respectively from 43.5 to 94.9 (p < 0.05) and from 96.9 to 100% (p > 0.05). In conclusion, according to the sanitary and psychological impact of lymph node invasion in patient with breast cancer, axillary ultrasonography is helpful in the management of this pathology.
Service de radiologie et de médecine nucléaire, hôpital du Point G Bamako, Mali.
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D001365:Axilla / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D014463:Ultrasonography