title: Pre-operative Ultrasonographic Evaluation of Axillary Lymph Nodes in Breast Cancer Patients: For Which Group Still of Additional Value and in Which Group Cause for Special Attention?
abstract: A non-invasive and widely available method for pre-operative evaluation of the axilla is axillary ultrasonography (US). The purpose of this study was to evaluate the diagnostic accuracy of axillary US and fine-needle aspiration cytology in a large cohort of breast cancer patients. The sensitivity and specificity of US and fine-needle aspiration cytology in our cohort of 1124 patients were 42.2% and 97.1%, respectively. As the number of axillary nodes increased, sensitivity increased. The percentage of false-negative US results was 18.9%; patients in this subgroup were significantly younger, had larger tumors, more often had lymph vascular invasion and were more likely to have estrogen receptor-positive tumors. Ultrasonography in combination with fine-needle aspiration cytology is useful in the pre-operative workup of breast cancer patients, especially patients with three or more nodal metastases. Special attention should be paid to younger women with larger tumors in whom a larger percentage of false-negative results are obtained.
authors.affiliation: Department of Surgery, Hospital Group Twente, Almelo, The Netherlands. Electronic address: y.moorman@zgt.nl.
authors.forename: A M
authors.initials: AM
authors.lastname: Moorman
authors.affiliation: Department of Radiology, Hospital Group Twente, Almelo, The Netherlands.
authors.forename: R L J H
authors.initials: RL
authors.lastname: Bourez
authors.affiliation: Department of Surgery, Hospital Group Twente, Almelo, The Netherlands.
authors.forename: D M
authors.initials: DM
authors.lastname: de Leeuw
authors.affiliation: Department of Surgery, Hospital Group Twente, Almelo, The Netherlands.
authors.forename: E A
authors.initials: EA
authors.lastname: Kouwenhoven
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D055815:Young Adult
keywords: Axillary lymph node dissection; Axillary ultrasonography; Breast cancer; False-negative ultrasonography; Fine-needle aspiration cytology; Pre-operative staging; Sentinel lymph node biopsy