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

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COD: 315-318 Categorie: ,

Mario Sianesi, Guido Ceci*, Andrea Ghirarduzzi, Paolo Del Rio, Anna Guazzi, Beatrice Pisanelli, Eugenia Martella, Andrea Ardizzoni, Beatrice Di Blasio, Maria Francesca Arcuri

Ann. Ital. Chir., 2009; 80: 315-318

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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).

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