[Preoperative staging of axillary lymph nodes in breast cancer: ultrasonographic parameters and ultrasound-guided core needle biopsy]

Radiologia. 2011 Nov-Dec;53(6):544-51. doi: 10.1016/j.rx.2010.12.007. Epub 2011 May 11.
[Article in Spanish]


Objective: To analyze the role of core needle biopsy of axillary lymph nodes with suspected metastases from breast cancer and to correlate the imaging and histologic findings.

Material and methods: We retrospectively studied 74 patients diagnosed with breast cancer who underwent ultrasound-guided core needle biopsy of axillary lymph nodes with characteristics suggestive of metastases on ultrasonography. The following ultrasonographic findings were considered suspicious for metastases: cortical thickening and changes in the hilar fat and/or non-hilar cortical vascular flow. Patients with negative findings after axillary biopsy underwent sentinel node biopsy.

Results: Core needle biopsy confirmed lymph node metastases in 47 (63.5%) patients. The 27 patients (36.5%) with negative findings after lymph node biopsy underwent sentinel node biopsy; 3 (11%) of these had a positive sentinel lymph node and underwent axillary lymph node resection. Of the 50 lymph nodes with metastases, 44 (88%) had cortical thickening, 20 (40%) had changes in the hilar fat, and 29 (58%) had non-hilar cortical vascular flow. All biopsies of lymph nodes with both cortical thickening and non-hilar cortical vascular flow were positive, yielding a 100% positive predictive value in this series.

Conclusions: Ultrasound-guided core needle biopsy of axillary lymph nodes that are suspicious for metastases from breast cancer at ultrasonography is a highly effective procedure that has low morbidity. Findings of cortical thickening and non-hilar cortical vascular flow in the same lymph node yield a positive predictive value of 100% in this series.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Axilla
  • Biopsy, Needle / methods*
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery
  • Carcinoma / diagnostic imaging*
  • Carcinoma / pathology*
  • Carcinoma / surgery
  • Female
  • Humans
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Staging
  • Preoperative Care / methods*
  • Retrospective Studies
  • Sentinel Lymph Node Biopsy / methods*
  • Ultrasonography, Interventional*