Axillary Ultrasound in Early-Stage Breast Cancer: Can it be relied upon for the decision of axillary dissection?

Dr. Siddharth Songadkar; Dr. Rajnish.R.Patel; Dr.Hitendra.K.Desai

Volume : VIII, Issue : XII, December - 2019

Axillary Ultrasound in Early-Stage Breast Cancer: Can it be relied upon for the decision of axillary dissection?

Dr. Siddharth Songadkar, Dr. Rajnish. R. Patel, Dr. Hitendra. K. Desai

Abstract :

Sentinel lymph node biopsy is the standard application for evaluating the axilla in patients with east cancer. The Z0011 trial conducted by The American College of Surgeons Oncology Group (ACOSOG) revealed that axillary dissection may be redundant in selected patients with positive sentinel node. This raises questions regarding the application of this result to ultrasound positive patients. This research therefore aimed to evaluate how accurate an ultrasound scan is for axillary node status in early–stage east carcinoma. The study included 78 newly diagnosed clinical T1–T2, N0 east cancer patients attending our hospital between August 2018 and September 2019. Sentinel lymph node biopsy and axillary lymph node clearance in the presence of sentinel lymph node metastasis was performed on all the east cancer patients. Axillary ultrasound reports were reviewed retrospectively and the results compared with surgical pathology results. The sensitivity and specificity of axillary ultrasound for detecting axillary lymph node disease was 69.2% and 98%, respectively, with a negative predictive value of 86.4% and positive predictive value of 94.7%. Given the high sensitivity and specificity, and high positive predictive value and negative predictive value demonstrated in the present study, axillary ultrasound represents a potential alternative to sentinel lymph node biopsy for staging of the axilla in early east cancer. Subsequent trials (SOUND) comp� axillary ultrasound alone with sentinel lymph node biopsy in early east cancer patients will provide additional information about the subject.