Role of axillary ultrasound in the preoperative diagnosis of lymph node metastases in patients affected by breast carcinoma.
OBJECTIVE
This study was conducted to evaluate the diagnostic accuracy of axillary ultrasound (US) alone or in combination with fine-needle-aspiration cytology (FNAC) in patients with breast carcinoma, in comparison with the final histological examination (sentinel node biopsy and/or axillary dissection).


METHODS
Between January 2005 and June 2008, we evaluated 427 breast cancer patients with axillary US. The findings were classified according to the following criteria: hilum and cortex morphology, ratio between longitudinal and transverse diameter and ratio between hilar and longitudinal diameter of the lymph node. Patients with breast lesions <or=3 cm (n=147) underwent FNAC of the most suspicious lymph node.


RESULTS
Overall concordance between axillary US and final histological examination was 85%, sensitivity was 72.3% and specificity was 93.4%. Concordance between FNAC and final histological examination was 93%, sensitivity was 88.1% and specificity was 100%.


CONCLUSIONS
In 48.3% of patients, the combination of axillary US and FNAC guided treatment decisions towards immediate axillary dissection, thus sparing the patients sentinel node biopsy, with a significant reduction of costs and hospitalization time.
Istituto di Radiologia Diagnostica ed Interventistica, Università di Torino, ASO San Giovanni Battista di Torino, Sede Molinette, Via Genova 3, 10126, Torino, Italy. andrea.luparia@hotmail.it
A
A
Luparia
P
P
Campanino
R
R
Cotti
D
D
Lucarelli
M
M
Durando
G
G
Mariscotti
G
G
Gandini
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D008875:Middle Aged; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary