DIAGNOSTIC ACCURACY OF AXILLARY ULTRASONOGRAPHY DETECTION OF AXILLARY LYMPH NODES METASTASIS IN MALIGNANT BREAST CARCINOMA PATIENTS TAKING HISTOPATHOLOGY AS GOLD STANDARD

Abstract

Objective: To determine the diagnostic accuracy of axillary ultrasonography in detecting axillary lymph node metastasis in patients with malignant breast carcinoma, using histopathology as the gold standard.

Study Design: Cross-Sectional Validation Study.

Study Setting: Department of Radiology, Shifa International Hospital, Islamabad, Pakistan.

Study Duration: Six months - October 2023 to April 2024

Methodology: This cross-sectional validation study included 270 female patients aged 18–60 years with histopathologically confirmed malignant breast carcinoma and clinically negative axillae. AUS findings were classified based on cortical thickness ≥3 mm and loss of fatty hilum. Histopathological analysis of lymph nodes following mastectomy served as the reference standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated.

Results: Out of 270 patients, AUS correctly identified 70 true positive and 170 true negative cases. It misclassified 12 false positives and 18 false negatives. The sensitivity of AUS was 79.5%, specificity 93.4%, PPV 85.4%, NPV 90.4%, and overall diagnostic accuracy was 88.9%.

Conclusion: Axillary ultrasonography demonstrated high sensitivity and specificity, indicating it is a reliable and effective modality for preoperative detection of axillary lymph node metastasis. Its non-invasive nature and high negative predictive value support its use in triaging patients and minimizing unnecessary surgical procedures. Integration of AUS with cytological confirmation is recommended for equivocal cases.