Utility of axillary ultrasound examination to select breast cancer patients suited for optimal sentinel node biopsy

Am J Surg. 2004 Jun;187(6):679-83. doi: 10.1016/j.amjsurg.2003.10.012.


Background: Because sentinel node (SN) biopsy (SNB) is known to produce false-negative results, we examined the usefulness of axillary ultrasound (AUS) in selecting patients suitable for optimal SNB.

Methods: A positive AUS finding (positive AUS) was defined as an echo pattern of a homogeneously hypoechoic SN without an echo-rich center, indicating massive to extensive nodal involvement. The identification of SNs was performed, and complete axillary dissection was carried out.

Results: A total of 262 women were enrolled into the study (T1 disease = 94; T2 disease = 145; and T3 disease = 23). The incidence of positive AUS increased with increasing size of breast tumor (P <0.0001). The overall identification and false-negative rates were 88.2% and 10.8%, respectively. However, when limited to AUS-negative patients, SNs were identified in 205 of 208 patients (98.6%), and the false-negative rate was 1.7%.

Conclusions: AUS should be included in the preoperative procedure for the selection of breast cancer patients suitable for SNB.

MeSH terms

  • Axilla / diagnostic imaging*
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / pathology*
  • False Negative Reactions
  • Female
  • Humans
  • Lymph Nodes / diagnostic imaging
  • Lymph Nodes / pathology
  • Middle Aged
  • Patient Selection
  • Predictive Value of Tests
  • Preoperative Care
  • Sensitivity and Specificity
  • Sentinel Lymph Node Biopsy*
  • Ultrasonography