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The Accuracy of Sonography in Detecting Abnormal Axillary Lymph Nodes When Breast Cancer Is Present

Department of Radiology, Fletcher Allen Health Care, Breast Ultrasound Division, Burlington, VT, louise.mobbs{at}vtmednet.org

Elisabeth A. S. Jannicky, BA

Department of Radiology, University of Vermont, Burlington, VT

Donald L. Weaver, MD

Department of Pathology, University of Vermont, Burlington, VT

Susan C. Harvey, MD

Department of Radiology, University of Vermont, Burlington, VT

This study evaluated the accuracy of sonography in detecting abnormal ipsilateral axillary lymph nodes in women with breast cancer. The authors retrospectively reviewed the sonographic findings and surgical pathology reports of 71 women who were diagnosed with breast cancer by ultrasound-guided biopsies. Results found in 71 cases that the sonographic specificity was 82%, whereas the sensitivity was only 40%. In 8 of the 17 cases (47%), sonography was suspicious for cancer, and the final surgical pathology was malignant. In 42 of 54 cases (77%), sonography of the axilla was not suspicious, and the final axillary node surgical pathology was negative. In 12 cases, sonographic images of the lymph nodes appeared normal, whereas the surgical pathology of the axillary nodes demonstrated malignancy. Ultrasound imaging has a high specificity when evaluating axillary lymph nodes and can be recommended when a suspicious finding is detected in the breast during diagnostic breast sonographic examination.

Key Words: ultrasound • axilla • lymph node • breast • cancer • sonography

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