Utility of axillary ultrasound examination to select breast cancer patients suited for optimal sentinel node biopsy

Sato, Kazuhiko; Tamaki, Kuniyoshi; Tsuda, Hitoshi; Kosuda, Shigeru; Kusano, Shoichi; Hiraide, Hoshio; Mochizuki, Hidetaka

doi:10.1016/j.amjsurg.2003.10.012

« Previous Next »The American Journal of Surgery
Volume 187, Issue 6 , Pages 679-683, June 2004

Utility of axillary ultrasound examination to select breast cancer patients suited for optimal sentinel node biopsy

Kazuhiko Sato, M.D.
- Department of Surgery I, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
- Corresponding author. Tel.: +81-42-995-1637; fax: +81-42-996-5205
Kuniyoshi Tamaki, M.D.
- Department of Surgery I, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
Hitoshi Tsuda, M.D., Ph.D.
- Department of Pathology II, National Defense Medical College, Tokorozawa, Saitama, Japan
Shigeru Kosuda, M.D., Ph.D.
- Department of Radiology, National Defense Medical College, Tokorozawa, Saitama, Japan
Shoichi Kusano, M.D., Ph.D.
- Department of Radiology, National Defense Medical College, Tokorozawa, Saitama, Japan
Hoshio Hiraide, M.D., Ph.D.
- Research Institute, National Defense Medical College, Tokorozawa, Saitama, Japan
Hidetaka Mochizuki, M.D., Ph.D.
- Department of Surgery I, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan

Received 13 May 2003; received in revised form 17 October 2003

Abstract

Background

Because sentinel node (SN) biopsy (SNB) is known to produce false-negative results, we examined the usefulness of axillary ultrasound (AUS) in selecting patients suitable for optimal SNB.

Methods

A positive AUS finding (positive AUS) was defined as an echo pattern of a homogeneously hypoechoic SN without an echo-rich center, indicating massive to extensive nodal involvement. The identification of SNs was performed, and complete axillary dissection was carried out.

Results

A total of 262 women were enrolled into the study (T1 disease = 94; T2 disease = 145; and T3 disease = 23). The incidence of positive AUS increased with increasing size of breast tumor (P <0.0001). The overall identification and false-negative rates were 88.2% and 10.8%, respectively. However, when limited to AUS-negative patients, SNs were identified in 205 of 208 patients (98.6%), and the false-negative rate was 1.7%.