title: Axillary ultrasound assessment in primary breast cancer: an audit of 653 cases.
abstract: Axillary lymph node status is an important factor in determining the prognosis and treatment in patients with invasive breast cancer. The introduction of the sentinel lymph node biopsy technique in the axilla has significantly reduced the number of patients requiring an axillary clearance procedure. However, a proportion of patients will be found to have axillary metastases after a sentinel node biopsy and will then require a second axillary surgical procedure. A retrospective audit of 653 consecutive patients presenting with invasive breast cancer showed a preoperative diagnosis rate of axillary disease of 23% using axillary ultrasound and fine-needle aspiration (FNA) together. We performed 232 axillary FNAs to diagnose 150 positive axillae. This avoided the need for a second operation in 150 women. The negative predictive value for axillary metastases using this technique was 79%. Overall accuracy was 84%.
authors.affiliation: Department of Imaging, Maidstone and Tunbridge Wells NHS Trust, Hermitage Lane, Barming, Maidstone, UK. pippa.mills@nhs.net
authors.forename: Pippa
authors.initials: P
authors.lastname: Mills
authors.forename: Ali
authors.initials: A
authors.lastname: Sever
authors.forename: Jenny
authors.initials: J
authors.lastname: Weeks
authors.forename: David
authors.initials: D
authors.lastname: Fish
authors.forename: Sue
authors.initials: S
authors.lastname: Jones
authors.forename: Peter
authors.initials: P
authors.lastname: Jones
mesh_terms: D000328:Adult; D001365:Axilla / Q000000981:diagnostic imaging* / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging* / Q000473:pathology; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy; D014463:Ultrasonography