title: [Preoperative staging of axillary lymph nodes in breast cancer: ultrasonographic parameters and ultrasound-guided core needle biopsy].
abstract: OBJECTIVE
  To analyze the role of core needle biopsy of axillary lymph nodes with suspected metastases from breast cancer and to correlate the imaging and histologic findings.
  
  
  METHODS
  We retrospectively studied 74 patients diagnosed with breast cancer who underwent ultrasound-guided core needle biopsy of axillary lymph nodes with characteristics suggestive of metastases on ultrasonography. The following ultrasonographic findings were considered suspicious for metastases: cortical thickening and changes in the hilar fat and/or non-hilar cortical vascular flow. Patients with negative findings after axillary biopsy underwent sentinel node biopsy.
  
  
  RESULTS
  Core needle biopsy confirmed lymph node metastases in 47 (63.5%) patients. The 27 patients (36.5%) with negative findings after lymph node biopsy underwent sentinel node biopsy; 3 (11%) of these had a positive sentinel lymph node and underwent axillary lymph node resection. Of the 50 lymph nodes with metastases, 44 (88%) had cortical thickening, 20 (40%) had changes in the hilar fat, and 29 (58%) had non-hilar cortical vascular flow. All biopsies of lymph nodes with both cortical thickening and non-hilar cortical vascular flow were positive, yielding a 100% positive predictive value in this series.
  
  
  CONCLUSIONS
  Ultrasound-guided core needle biopsy of axillary lymph nodes that are suspicious for metastases from breast cancer at ultrasonography is a highly effective procedure that has low morbidity. Findings of cortical thickening and non-hilar cortical vascular flow in the same lymph node yield a positive predictive value of 100% in this series.
authors.affiliation: Servicio de Radiodiagnóstico, Hospital General Universitario de Ciudad Real, Ciudad Real, España. torresmy@hotmail.com
authors.forename: M Y
authors.initials: MY
authors.lastname: Torres Sousa
authors.forename: M E
authors.initials: ME
authors.lastname: Banegas Illescas
authors.forename: M L
authors.initials: ML
authors.lastname: Rozas Rodríguez
authors.forename: M
authors.initials: M
authors.lastname: Arias Ortega
authors.forename: L M
authors.initials: LM
authors.lastname: González López
authors.forename: J J
authors.initials: JJ
authors.lastname: Martín García
authors.forename: L
authors.initials: L
authors.lastname: Ruiz Ortega
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001707:Biopsy, Needle / Q000379:methods*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D018084:Ultrasonography, Interventional