TO DETERMINE THE ACCURACY OF AXILLARY ULTRASOUND IN THE ASSESSMENT OF METASTATIC AXILLARY NODES IN BREAST CANCER PATIENTS AT A TERTIARY CARE CENTER IN PAKISTAN

Abstract

Background:
Ultrasound evaluation of the axilla and guided core biopsy of the suspicious axillary lymph nodes play a pivotal role in breast cancer staging. Correct preoperative diagnosis of axillary nodal status spares the patient from a second operative procedure
Objective:
To determine the accuracy of axillary ultrasound in the assessment of metastatic axillary nodes in breast cancer patients at a tertiary care center in Pakistan.
Methodology:
This descriptive study was conducted in the Department of Radiology, The Aga Khan University Hospital, Karachi from January to December 2019.
Patients with known breast cancer and clinically negative axilla who underwent axillary ultrasound were selected. Patients who had benign-appearing lymph nodes on ultrasound underwent sentinel lymph node biopsy and patients who had suspicious axillary lymph nodes were subjected to ultrasound-guided core needle biopsy. The results of SLNB and histopathology were compared with ultrasound findings and sensitivity, specificity, positive and negative predictive values for axillary ultrasound were calculated.
Result:
A total of 217 patients underwent axillary ultrasound, out of which 139 had suspicious lymph nodes and were subjected to ultrasound core needle biopsy, whereas 80 patients had normal-appearing lymph nodes were subjected to SLNB procedure. The calculated sensitivity, specificity, PPV, NPV and accuracy were 83.51%,51.58%,55.47%, 95% and 65% respectively.
Conclusion:
This study shows that axillary ultrasound has high sensitivity and negative predictive values for the evaluation of axillary lymph nodes in breast cancer patients. Core needle node biopsy as a sampling technique is a safe, easy, and accurate method. It should be used to avoid unnecessary axillary dissection.