The role of axillary ultrasound in the detection of metastases from primary breast cancers

BACKGROUND: The value of diagnostic axillary ultrasound (AUS) in the preoperative evaluation of lymph nodes for breast cancer patients has yet to be completely clarified. METHODS: Results of AUS were reviewed for all patients with invasive cancers who were clinically node negative (cN0) and had subsequent axillary lymphadenectomy. Patients with positive ultrasound-guided node core biopsies bypassed sentinel lymph node biopsy (SLNB) and had axillary lymph node dissection, whereas those with sonographically normal nodes or benign/nondiagnostic biopsy results had SLNB. RESULTS: Of 128 cN0 patients with invasive cancer, 23 (18%) had abnormal axillary AUS. Of 18 core biopsies, 12 (67%) were malignant. SLNB was positive in 19 of 110 (17%) patients. ALND was performed in 32 (25%) patients. For determining axillary metastases, AUS sensitivity was 16 of 31 (52%), specificity was 90 of 97 (93%), the positive predictive value was 16 of 23 (69%), and the negative predictive value was 90 of 105 (86%). CONCLUSIONS: AUS examination was a valuable method for evaluating the axilla in newly diagnosed cN0 breast cancer patients. (C) 2013 Elsevier Inc. All rights reserved.