Abstract 100P
Background
Accurate preoperative assessment of axillary lymph nodes is crucial in breast cancer prognosis and treatment planning. Various imaging modalities, such as computed tomography (CT) and ultrasound, are utilized for this purpose. We compared CT and ultrasound findings in breast cancer patients undergoing sentinel lymph node biopsy (SLNB) and histological examination to evaluate their accuracy in detecting metastatic axillary lymph nodes. The aim of this study is to assess the efficacy of CT and ultrasound in detecting axillary lymph node metastases in breast cancer patients.
Methods
We conducted a study involving 340 consecutive patients (mean age 48.05 years, range [25-76 years]) diagnosed with early breast cancer (T1-2, N0-1) between 2021 and 2023. All patients underwent SLNB. SLNB was performed using indocyanine green with Fluobeam (Fluoptics). Prior to surgery, each patient underwent CT-scan and ultrasound examination. On CT images of axillary LN we analyzed following diagnostic signs: size (short axis more or less than 10 mm), shape, cortical thickness and fat content. Histological examination of dissected LN was used as as the reference standard. The sensitivity, specificity, the positive predictive value (PPV), negative predictive value (NPV), and accuracy of both methods were calculated. Analyses were made on a patient basis.
Results
The sensitivity, specificity, PPV, NPV, and accuracy of CT for the detection of axillary lymph node metastases were 49%, 71%, 36%, 81%, and 66 %, respectively. For ultrasound it was 67%, 84%, 68%, 84%, and 79%, respectively.
Conclusions
Negative CT findings are insufficient to exclude axillary lymph node metastases and cannot replace invasive approaches for axillary staging. Ultrasound demonstrates higher diagnostic accuracy and sensitivity for identifying axillary lymph node metastases in early-stage breast cancer patients. While CT remains useful for staging breast cancer patients, its indications should be limited to specific clinical situations, and further evaluation is necessary before clinical recommendation. Specificity can potentially be improved by performing fine-needle biopsy under ultrasound guidance.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.