Ionică M, Ilina RȘ, Neagoe OC. Ultrasound Pretreatment Lymph Node Evaluation in Early-Stage Breast Cancer: Should We Biopsy High Suspicion Nodes?
Clin Pract 2023;
13:1532-1540. [PMID:
38131683 PMCID:
PMC10742685 DOI:
10.3390/clinpract13060134]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/05/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND
With the growing incidence of breast cancer, efficient and correct staging is essential for further treatment decisions. Axillary ultrasound (US) remains the most common method for regional nodal involvement assessment. The aim of this study was to evaluate whether high-risk US features can accurately predict axillary lymph node metastasis.
METHODS
A total of 150 early-stage breast cancer patients (T1 or T2) were prospectively included in the study. Based on axillary US, patients were classified as normal, low-risk, or high-risk, with all patients in the low-risk and high-risk groups undergoing fine-needle aspiration (FNAB) and core-needle biopsies.
RESULTS
For the low-risk US group, a lower prediction rate of axillary nodal metastasis was achieved than for the group with high-risk features, recording a sensitivity of 66.6% vs. 89.2%, a specificity of 57.1% vs. 100%, a positive predictive value (PPV) of 26.6% vs. 100%, a negative predictive value (NPV) of 88% for both groups, and an accuracy of 58.9% vs. 94%, respectively. FNAB resulted in more false-negative results compared to core-needle biopsy in both low-risk and high-risk US groups.
CONCLUSIONS
Our findings suggest that high-risk US features can predict axillary lymph node metastasis with high accuracy.
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