Abstract：
OBJECTIVE: This study aimed to determine the ability of axillary ultrasonography to predict the number of lymph nodes with metastases found in sentinel node axillary surgery or axillary lymph node resection in patients recently diagnosed with breast cancer after percutaneous biopsy.
METHODS: This prospective study included patients diagnosed with invasive breast cancer by percutaneous biopsy. Axillary lymph nodes were classified at ultrasound examination as suspicious or not suspicious, and the number of suspicious nodes was compared with the number classified as suspicious in the surgical specimen.
RESULTS: We included 142 patients, 4 of whom had bilateral cancer; 133 of the 146 tumors were clinically classified as T1-T2 N0. The median number of suspicious lymph nodes at ultrasound was 2 (1-6), and the median number of suspicious lymph nodes in the surgical biopsy specimen was 1 (1-16); the difference was not significant (p=0.1). The correlation between the number of positive lymph nodes on axillary ultrasound and the number of metastatic lymph nodes in the surgical specimen was 72.7% p=0.0002 and the concordance was 79% (95%CI 62.4%-95.6%) p=0.0001. For diagnosing high axillary tumor load (≥3 metastatic lymph nodes) versus low axillary tumor load (<3 metastatic lymph nodes), axillary ultrasound had 86.6% sensitivity, 83.3% specificity, 92% PPV, and 71.4% NPV.
CONCLUSIONS: Our results show that preoperative axillary ultrasound can differentiate between low and high tumor load and can be used as a tool to select the type of treatment. These results need to be confirmed in randomized multicenter studies.
METHODS: This prospective study included patients diagnosed with invasive breast cancer by percutaneous biopsy. Axillary lymph nodes were classified at ultrasound examination as suspicious or not suspicious, and the number of suspicious nodes was compared with the number classified as suspicious in the surgical specimen.
RESULTS: We included 142 patients, 4 of whom had bilateral cancer; 133 of the 146 tumors were clinically classified as T1-T2 N0. The median number of suspicious lymph nodes at ultrasound was 2 (1-6), and the median number of suspicious lymph nodes in the surgical biopsy specimen was 1 (1-16); the difference was not significant (p=0.1). The correlation between the number of positive lymph nodes on axillary ultrasound and the number of metastatic lymph nodes in the surgical specimen was 72.7% p=0.0002 and the concordance was 79% (95%CI 62.4%-95.6%) p=0.0001. For diagnosing high axillary tumor load (≥3 metastatic lymph nodes) versus low axillary tumor load (<3 metastatic lymph nodes), axillary ultrasound had 86.6% sensitivity, 83.3% specificity, 92% PPV, and 71.4% NPV.
CONCLUSIONS: Our results show that preoperative axillary ultrasound can differentiate between low and high tumor load and can be used as a tool to select the type of treatment. These results need to be confirmed in randomized multicenter studies.
摘要：
目的：本研究旨在确定腋窝超声对前哨淋巴结腋窝手术或腋窝淋巴结切除术中发现的淋巴结转移的预测能力。
方法：这项前瞻性研究包括经皮穿刺活检诊断为浸润性乳腺癌的患者。腋窝淋巴结在超声检查时被分类为可疑或不可疑，并将可疑淋巴结的数量与手术标本中分类为可疑的数量进行比较。
结果：我们纳入了142例患者，其中4例患有双侧癌症；146例肿瘤中有133例临床分类为T1-T2N0。超声检查可疑淋巴结数目中位数为2个(1-6个),手术活检标本中可疑淋巴结的中位数为1（1-16）；差异无统计学意义（p=0.1）。腋窝超声阳性淋巴结数量与手术标本中转移淋巴结数量的相关性为72.7%p=0.0002，一致性为79%(95CI62.4%-95.6%)p=0.0001。对于诊断高腋窝肿瘤负荷（≥3个转移性淋巴结）与低腋窝肿瘤负荷（<3个转移性淋巴结），腋窝超声敏感度为86.6%,83.3%的特异性，92%PPV,和71.4%的净现值。
结论：我们的结果表明，术前腋窝超声可以区分低肿瘤负荷和高肿瘤负荷，可以作为选择治疗类型的工具。这些结果需要在随机多中心研究中得到证实。
方法：这项前瞻性研究包括经皮穿刺活检诊断为浸润性乳腺癌的患者。腋窝淋巴结在超声检查时被分类为可疑或不可疑，并将可疑淋巴结的数量与手术标本中分类为可疑的数量进行比较。
结果：我们纳入了142例患者，其中4例患有双侧癌症；146例肿瘤中有133例临床分类为T1-T2N0。超声检查可疑淋巴结数目中位数为2个(1-6个),手术活检标本中可疑淋巴结的中位数为1（1-16）；差异无统计学意义（p=0.1）。腋窝超声阳性淋巴结数量与手术标本中转移淋巴结数量的相关性为72.7%p=0.0002，一致性为79%(95CI62.4%-95.6%)p=0.0001。对于诊断高腋窝肿瘤负荷（≥3个转移性淋巴结）与低腋窝肿瘤负荷（<3个转移性淋巴结），腋窝超声敏感度为86.6%,83.3%的特异性，92%PPV,和71.4%的净现值。
结论：我们的结果表明，术前腋窝超声可以区分低肿瘤负荷和高肿瘤负荷，可以作为选择治疗类型的工具。这些结果需要在随机多中心研究中得到证实。
