Preoperative axillary ultrasound scan: its accuracy in assessing the axillary nodal status in carcinoma breast

The aim of this study is to report the accuracy of ultrasound scan in axillary node staging in breast carcinoma. Eighty-four patients with breast cancer attending a breast clinic were entered in this study and axillary ultrasound scan was performed using a 7.5 MHz probe. The sensitivity of ultrasound scan in detection of axillary nodal metastasis was 74% with a specificity of 89%, positive predictive value of 87%, negative predictive value of 84% and overall accuracy of 83%. The sensitivity was low (38%) when nodes were small or non-palpable. The Likelihood Ratio (LR) for the test positive was 6.37 and the LR for the test negative was 0.29. The combined assessment (Clinical Examination+Ultrasound scan+FNA) of axillary node status was very sensitive--88%, with a specificity of 100%, positive predictive value of 100%, negative predictive value of 88% and overall accuracy of 92%. Ultrasound scan of axilla is a valuable method of preoperatively assessing axillary nodal status, and may prove useful in managing patients with breast cancer.