Ultrasound And Mri Evaluation Of Axillary Lymph Nodes In Breast Cancer Patients

Introduction/Background About 30–40% of newly diagnosed breast cancer patients have axillary nodal metastasis. The aim of this study is to analyze the diagnostic performance of MRI and ultrasound for the detection of axillary disease. Methodology The medical records of 45 patients diagnosed with breast cancer in the last 6 months have been retrospectively reviewed, including the MRI and ultrasound reports. Sixteen patients were excluded due to having the imaging performed in a different centre. Results Twenty-nine patients were finally included. Median age was 58 years old (37–76). Histological type was ductal invasive carcinoma in 22 patients (75.9%) and lobular invasive carcinoma in 7 (24.1%). The molecular subtype was Her2 in 12 patients (41.4%), Luminal A in 9 (31%), Luminal B in 4 (13,8%) and triple negative in 4 (13,8%). Six patients had bulky nodes on clinical examination. Over all patients 12 had suspicious nodes on MRI (44.4%) and 11 on ultrasound (37.9%). A fine-needle aspiration (FNA) of the nodes was performed in 13 patients (44.8%), 9 of them had metastasis of carcinoma (31%) and had neoadjuvant chemotherapy. Twenty patients had upfront surgery, including sentinel lymph node biopsy, in 12 the sentinel node was negative, 2 had micrometastasis and 6 had macrometastasis. At the time of the operation a systematic axillary lymph node dissection was performed in 15 patients (9 with positive FNA and 6 with macrometastasis in sentinel node). The sensitivity in evaluation nodal disease was 78.6% for ultrasound and 91.7% for MRI, the specificity 53.3% for ultrasound and 73.8% for MRI. The negative predictive value was 61.1% for ultrasound and 73.3% for MRI. Conclusion The MRI seems to be a more accurate method for detection of nodal disease in breast cancer patients. Disclosure Nothing to disclose.