Clinical value of ultrasound-guided core needle biopsy for detecting axillary lymph node metastasis in breast cancer / 军事医学

ABSTRACT

Objective To analyze the clinical value of ultrasound and ultrasound-guided core needle biopsy ( UNB) in the evaluation of axillary lymph node metastasis for breast cancer.Methods A total of 454 cases of breast cancer treated between June 2008 and August 2014 at our hospital were retrospectively analyzed.UNB was performed on patients with abnormal ultrasonic diagnosis of axillary lymph nodes.Among them, 354 cases underwent neoadjuvant chemotherapy or endocrine therapy while 100 cases underwent surgery after UNB.The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and false negative rate of ultrasound and UNB were evaluated.Results Among the 454 patients with abnormal axillary lymph nodes of ultrasound imaging, the metastasis rate with UNB was 70.9%,while the negative rate was 29.1%.Among the 100 cases who underwent surgery after UNB, the metastasis rate was 25% while the ultrasound imaging lymph node longitudinal and transversal ( L/T)≤1.5,the lymph node size>1 cm,and the metastasis rate was 92.3%(12/13).UNB showed that sensitivity was 64.1%, specificity 100%, accuracy 86%, positive predictive value 100%, negative predictive value 81.3%,and false negative rate was 18.7%.The results of UNB seemed consistent with those of postoperative pathological diagnosis, the Kappa value being 0.685.Based on 2 and 3 needles, the above mentioned 6 indices were 50% and 77.8%, 100% and 100%, 77.8% and 92.5%, 100% and 100%, 71.4% and 89.7%,and 28.6%and 10.3%, respectively.The Kappa value of UNB based on 3 needles was higher than on 2 needles (0.822 vs 0.526 ) .Conclusion Ultrasound is a valuable tool for detecting axillary lymph node metastasis in breast cancer.UNB can accurately determine the axillary lymph node metastasis status.UNB based on 3 needles shows a higher accuracy than on 2 needles.