Use of axillary ultrasonography in breast cancer: a useful tool to reduce sentinel node procedures
Mario Sianesi 1, Guido Ceci 1, Andrea Ghirarduzzi 1, Paolo Del Rio 1, Anna Guazzi 1, Beatrice Pisanelli 1, Eugenia Martella 2, Andrea Ardizzoni 1, Beatrice Di Blasio 1, Maria Francesca Arcuri 1
Affiliations
Article Info
1 Unit of Oncology , University Hospital of Parma, Parma, Italy, Department of Surgical Science, General Surgery and Organ transplantation, University of Parma, Parma, Italy
2 Unit of Pathology, University Hospital of Parma, Parma, Italy, Department of Surgical Science, General Surgery and Organ transplantation, University of Parma, Parma, Italy
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).
Keywords
- Axillary ecography
- Axillary dissection
- Breast cancer
- Fine needle aspiration
- Sentinel lymphnode
