Diagnostic Accuracy of Axillary Ultrasonography for Differentiating Benign and Malignant Lymph Nodes in Breast Cancer Patients
Axillary Ultrasound Accuracy
DOI:
https://doi.org/10.69750/dmls.02.03.099Keywords:
Ultrasound, Axillary lymph nodes, Diagnostic accuracy, Histopathology, Preoperative stagingAbstract
Background: Reliable evaluation of axillary lymph nodes before surgery is essential for determining prognosis and tailoring treatment in breast cancer care. Although surgical techniques such as sentinel-node biopsy remain the definitive standard, they are invasive and can cause considerable morbidity. High-resolution ultrasonography provides a non-invasive alternative.
Objectives: This study aimed to measure how accurately ultrasound distinguishes malignant from benign axillary nodes, using histopathology as the reference method.
Methods: We carried out a prospective observational study in a tertiary oncology hospital from January 2022 through December 2023. Eighty adults with biopsy-confirmed breast carcinoma underwent preoperative axillary ultrasound performed by senior breast radiologists with 7–15 MHz linear transducers. Each lymph node was assessed for size, shape, cortical thickness, integrity of the fatty hilum, and Doppler vascular pattern. Tissue obtained by surgical excision or image-guided core biopsy supplied the histological verdict. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated, and agreement with histology was expressed using Cohen’s κ statistic.
Results: Histological analysis identified metastasis in 42 patients (52.5 %) and benign pathology in 38 (47.5 %). Ultrasound achieved an overall accuracy of 86.3 %, with sensitivity 85.7 %, specificity 86.8 %, PPV 87.8 %, and NPV 84.6 %. Concordance between sonography and histopathology was substantial (κ = 0.72; p < 0.001).
Conclusion: When conducted under standardized conditions, axillary ultrasound reliably differentiates malignant from benign lymph nodes in breast-cancer patients. Incorporating this modality into routine preoperative work-ups could decrease reliance on invasive staging procedures and their attendant complications. Larger multicentre studies are warranted to confirm these findings and refine sonographic criteria further.
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Copyright (c) 2025 Hina Farooq, Saba Aslam , Anaab Gul, Saba Masud, Binish Zaidi , Syed Ahmad Hassan Waqas Subzwari (Author)
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