EVALUATION OF AXILLARY LYMPH NODES STATUS IN BREAST CANCER: ROLE OF ULTRASOUND GUIDED CORE NEEDLE BIOPSY AND ULTRASONOGRAPHIC PARAMETERS IN PREOPERATIVE STAGING

Abstract

Background: Accurate preoperative assessment of axillary lymph nodes in breast cancer is challenging. This study evaluated ultrasonographic parameters and ultrasound-guided core needle biopsy to improve detection of nodal metastases, guide surgical planning, and potentially reduce unnecessary axillary dissections.

Objectives: To evaluate the diagnostic accuracy of ultrasonographic parameters and ultrasound-guided core needle biopsy in detecting malignant axillary lymph nodes in breast cancer, using histopathology as the gold standard.   

Duration: Six months w.e.f  01-05-2023 to 31-10-2023

Methodology: After informed consent, all patients underwent high-resolution axillary ultrasonography, followed by ultrasound-guided core needle biopsy of all lymph nodes. Multiple core samples were sent for histopathology, and all patients received definitive surgical management. This allowed direct comparison of ultrasonography and core biopsy findings with histopathology, enabling accurate assessment of false positives, false negatives, and diagnostic performance.

Results: A total of 270 participants with a mean age of 51.4 ± 12.35 years were included, with 61% of axillary lymph nodes confirmed malignant on histopathology, consistent across age groups. Ultrasonographic parameters showed a sensitivity of 86.7%, specificity of 70.5%, and accuracy of 80.4%, while ultrasound-guided core needle biopsy demonstrated superior performance with 93.9% sensitivity, 89.5% specificity, and 92.2% accuracy.

Conclusion: Ultrasonography and ultrasound-guided core needle biopsy provide reliable preoperative assessment of axilliary lymph nodes in breast cancer. Core needle biopsy demonstrates higher sensitivity, specificity, and accuracy. Their use improves staging accuracy, informs surgical planning, and may reduce unnecessary axillary dissections, ultimately enhancing patient management and treatment outcomes.