title: Use of axillary ultrasonography in breast cancer: a useful tool to reduce sentinel node procedures.
abstract: OBJECTIVE
  The lymph node sentinel method is today used for staging the axillary lymph node stations. Ultrasonography is widely available and inexpensive method to study axillary status.
  
  
  METHODS
  One hundred fourteen patients were studied consecutively using axillary ultrasonography and ultrasound guided fine needle aspiration of the lymph node. We used ATL Ultramark 9 with 5-7.5 MHz multiple frequency linear probe or Aloka SSDD-1400 with 7.5 MHz linear probe.
  
  
  RESULTS
  One hundred fourteen patients were examined; six were excluded because of definitive histological diagnosis of non-infiltrating carcinoma. 106 had monofocal carcinomas, 2 had bifocal carcinoma in 104/108 ultrasonography was carried out successfully. The axillary cytological examination was positive in 18 cases (17.3%) who were subjected to axillary examination. 86 patients were subjected to sentinel lymph node biopsy: positive 13 cases (6 micrometastases). 31 cases/104 (29.8%) showed positive axilla. Sensitivity of ultrasonography was 58%, 100%specificity. Predictive positive value 100%, Negative value 84.9% for an accuracy of 87.5%.
  
  
  CONCLUSIONS
  Ultrasonography is useful in all cases eligible to sentinel lymph node examination; the minimum cost of the procedure and of the human resources is amply rewarded by the direct indication for surgical axillary dissection in case of a positive result (17.3% in our experience).
authors.affiliation: Department of Surgical Science, General Surgery and Organ transplantation, University of Parma, Parma, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Sianesi
authors.forename: Guido
authors.initials: G
authors.lastname: Ceci
authors.forename: Andrea
authors.initials: A
authors.lastname: Ghirarduzzi
authors.forename: Paolo
authors.initials: P
authors.lastname: Del Rio
authors.forename: Anna
authors.initials: A
authors.lastname: Guazzi
authors.forename: Beatrice
authors.initials: B
authors.lastname: Pisanelli
authors.forename: Eugenia
authors.initials: E
authors.lastname: Martella
authors.forename: Andrea
authors.initials: A
authors.lastname: Ardizzoni
authors.forename: Beatrice
authors.initials: B
authors.lastname: Di Blasio
authors.forename: Maria Francesca
authors.initials: MF
authors.lastname: Arcuri
mesh_terms: D001365:Axilla / Q000000981:diagnostic imaging*; D044963:Biopsy, Fine-Needle; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D018567:Breast Neoplasms, Male / Q000000981:diagnostic imaging* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000473:pathology; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy; D014463:Ultrasonography