Correlation between preoperative axillary ultrasound and histopathology of resected lymph nodes in patients with carcinoma breast

Ab. Hamid Wani, Anish Gupta, Nasib Chand Dhigra, Narinder Sing, Javid Iqbal


Background: Axillary Ultrasound is an important tool in assessing regional lymph node status in women who are node negative clinically as many of them will prove to have axillary lymph node involvement on histopathology. The aim of the present study was to establish the role of axillary ultrasound in preoperative assessment of lymph node status in women with carcinoma breast and to correlate the findings of axillary ultrasound with the histopathology of resected axillary nodes.

Methods: Forty patients (all women) were included in this study and the preoperative axillary ultrasound was done to know the status of axillary lymph nodes and the findings were correlated with histopathological findings of the resected nodes.

Results: The sensitivity of axillary ultrasound was found to be 66.67%, specificity was 87.5%, accuracy 75%, positive predictive value (PPV) of 88.89% and negative predictive value of 63.4%.

Conclusions: Axillary ultrasound is very important tool in assessing preoperative axillary lymph node status in patients with carcinoma breast. It is also important in assessment after inadequate axillary dissection and for follow up of non-treated axilla.


Axillary ultrasound. Fine needle aspiration cytology, National Health Service screening programme in UK

Full Text:



Alvarez S, Añorbe E, Alcorta P, López F, Alonso I, Cortés J. Role of sonography in the diagnosis of axillary lymph node metastases in breast cancer: a systematic review. Am J Roentgenol. 2006 May;186(5):1342-8.

Ambroise M, Ghosh M, Mallikarjuna VS, Kurian A. Immunohistochemical profile of breast cancer patients at a tertiary care hospital in South India. Asian Pac J Cancer Prev. 2011 Jan 1;12(3):625-9.

Bosch AM, Kessels AG, Beets GL, Rupa JD, Koster D, van Engelshoven JM, et al. Preoperative estimation of the pathological breast tumour size by physical examination, mammography and ultrasound: a prospective study on 105 invasive tumours. Eur J Radiol. 2003 Dec 1;48(3):285-92.

Bruneton JN, Caramella E, Hery M, Aubanel D, Manzino JJ, Picard JL. Axillary lymph node metastases in breast cancer: preoperative detection with US. Radiology. 1986 Feb;158(2):325-6.

Choi YJ, Ko EY, Han BK, Shin JH, Kang SS, Hahn SY. High-resolution ultrasonographic features of axillary lymph node metastasis in patients with breast cancer. Breast. 2009 Apr 1;18(2):119-22.

Luparia A, Campanino P, Cotti R, Lucarelli D, Durando M, Mariscotti G, et al. Role of axillary ultrasound in the preoperative diagnosis of lymph node metastases in patients affected by breast carcinoma. Med Radiol. 2010 Mar 1;115(2):225-37.

Bajwa R, Zulfiqar T. Association of fine needle aspiration cytology with tumor size in palpable breast lesions. Biomedica. 2010 Jul;26:124-9.

Rajesh NG. Correlation of ER, PR and Her-2/neu immunoprofile with the morphological prognostic factors in breast cancer- South Indian data. Regional Cancer Centre Bulletin 2010;2:27-9.

Patil VW, Singhai R, Patil AV, Gurav PD. Triple-negative (ER, PgR, HER-2/neu) breast cancer in Indian women. Breast Cancer: Targets and Therapy. 2011;3:9.

Jain S A, Aggrawal l, Ameta A et al, Study of ER, PR and HER-2 /neu expression in breast cancer in Northern India. IOSR-JDMS. 2014; 13:9-19.

Podkrajsek M, Music MM, Kadivec M, Zgajnar J, Besic N, Pogacnik A, et al. Role of ultrasound in the preoperative staging of patients with breast cancer. Eur Radiol. 2005 May 1;15(5):1044-50.

Lee B, Lim AK, Krell J, Satchithananda K, Coombes RC, Lewis JS, et al. The efficacy of axillary ultrasound in the detection of nodal metastasis in breast cancer. Am J Roentgenol. 2013 Mar;200(3):W314-20.

Sato K, Tamaki K, Tsuda H, Kosuda S, Kusano S, Hiraide H, et al. Utility of axillary ultrasound examination to select breast cancer patients suited for optimal sentinel node biopsy. The Am J Surg. 2004 Jun 1;187(6):679-83.

Tahir M, Osman KA, Shabbir J, Rogers C, Suarez R, Reynolds T, Bucknall T. Preoperative axillary staging in breast cancer-saving time and resources. Breast J. 2008 Jul;14(4):369-71.

Nori J, Vanzi E, Bazzocchi M, Bufalini FN, Distante V, Branconi F, et al. Role of axillary ultrasound examination in the selection of breast cancer patients for sentinel node biopsy. The Am J Surg. 2007 Jan 1;193(1):16-20.