AXILLARY NODE METASTASIS IN CARCINOMA OF THE BREAST: A COMPARISON OF CLINICAL/SURGICAL/HISTOPATHOLOGICAL FINDING

Abstract

Background: Breast carcinoma is the most prevalent malignancy among women globally and a major cause of cancer-related deaths. Axillary lymph node status is a crucial prognostic indicator in determining disease staging, treatment planning, and overall survival.

Objectives: To assess the clinical, surgical, and histopathological findings of axillary lymph node metastasis in patients with breast carcinoma.

Study Design & Setting: A cross-sectional comparative study was conducted at the Department of General Surgery, Shaik Zayed Hospital Lahore from April 2024 to April 2025.

Methodology: A total of 120 female patients with histologically confirmed breast carcinoma undergoing modified radical mastectomy were included. Clinical evaluation of axillary lymph nodes was performed by palpation, followed by intraoperative surgical assessment. Excised lymph nodes were examined histopathologically for metastatic involvement. Data were analyzed using SPSS version 26. Sensitivity, specificity, and diagnostic accuracy of clinical and surgical findings were calculated with histopathology as the reference standard.

Results: Among 120 patients, 68 (56.7%) showed clinically palpable nodes, while 74 (61.7%) were surgically suspected. Histopathology confirmed metastasis in 79 (65.8%) cases. The correlation between clinical and histopathological findings was significant (p < 0.05), and surgical assessment demonstrated higher diagnostic accuracy (82.5%) compared to clinical evaluation (74.1%).

Conclusion: Surgical assessment of axillary lymph nodes correlates more accurately with histopathological findings than clinical evaluation, emphasizing the importance of intraoperative evaluation for precise staging and management.