Preoperative Evaluation of Lymph Node Metastasis with Using Ultrasonography for Examining the Axilla in Early Stage Breast Cancer.
- Author:
Sung Eun HWANG
1
;
Woo Kyung MOON
;
Nariya CHO
;
Wonshik HAN
;
Sung Won KIM
;
Hyuk Jai SHIN
;
Ki Tae HWANG
;
Jeong Eon LEE
;
Yeo Kyu YOUN
;
Seung Keun OH
;
Dong Young NOH
Author Information
- Publication Type:Original Article
- Keywords: Breast cancer; Axillary lymph node metastasis; Ultrasonography
- MeSH: Axilla*; Breast Neoplasms*; Breast*; Carcinoma, Ductal; Humans; Lymph Node Excision; Lymph Nodes*; Neoplasm Metastasis*; Sensitivity and Specificity; Sentinel Lymph Node Biopsy; Ultrasonography*
- From:Journal of Breast Cancer 2006;9(2):115-120
- CountryRepublic of Korea
- Language:Korean
- Abstract: PURPOSE: The axillary lymph node status is the most significant prognostic factor in breast cancer. The development of tools to accurately evaluate the axillary lymph node status with less morbidity has been the important treatment issue. Although sentinel lymph node biopsy is the promising alternative to axillary lymph node dissection, the high false negative rate of this procedure is a considerable problem. This study aimed to evaluate the efficacy of performing preoperative axillary ultrasonography (US) for predicting axillary lymph node metastasis. METHODS: Between January 2003 and December 2004, preoperative axillary US was performed in 646 patients who were suffering with T1 or T2 infiltrating ductal carcinoma and they had no palpable axillary lymph nodes. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of preoperative axillary US findings were 82.8%, 93.2%, 86.3%, 91.2%, and 89.6%, respectively. The positive and negative predictive values for performing axillary US findings for tumors with a size < or =2cm were 76.2% and 92.5%, respectively. For tumors with a size > 2cm, the positive and negative predictive values were 90.6 and 89.4, respectively. CONCLUSION: We found that performing preoperative axillary US is a relatively accurate and useful non-invasive method for assessing axillary lymph node metastasis. It showed the potential to replace sentinel lymph node biopsy in tumors > or = 2cm in size with low false negative rate. If we can improve the positive predictive value of US finding by using strict decision criteria, and especially for the tumors >2cm in size, then axillary lymph node dissection might be recommended for the cases with positive US finding.
