Use of axillary ultrasonography in breast cancer: a useful tool to reduce sentinel node procedures

Abstract

AIM OF THE STUDY: The lymphnode sentinel method is today used for staging the axillary lymphnode stations. Ultrasonography is widely available and inexpensive method to study axillary status.

METHODS:Onehundred forteen patients were studied consecutively using axillary ultrasonography and ultrasound guided fine needle aspiration of the lymphnode. We used ATL Ultramark 9 with 5-7,5 MHz multiple frequency linear probe or Aloka SSDD-1400 with 7,5 MHz linear probe.

RESULTUS: Onehundred forteen patients were examined; six were excluded because of definitive histological diagnosis of non-infiltranting carcinoma. 106 had monofocal carcinomas, 2 had bifocal carcinoma. in 104/108 ultrasonography was carried out successfully. The axillary cytological examination was positive in 18 cases (17.3%) who were subjected to axillary examination. 86 patients were subjected to sentinel lymphnode biopsy :positive 13 cases (6 micrometastases). 31 cases/104(29.8%) showed positive axilla. Sensitivity of ultrasonography was 58%, 100%specificity.Predictive positive value 100%, Negative value 84.9% for an accuracy of 87.5%.

DISCUSSION: Ultrasonography is useful in all cases eligible to sentinel lymphnode examination ; the minimum cost of the procedure and of the human resources is amply rewarded by the direct indication for surgical axillary dissection in case of a positive result (17.3 % in our experience).