The accuracy of preoperatively predicting axillary lymph node status in breast cancer patients by ultrasonography and MRI / 中华普通外科杂志

ABSTRACT

Objective To evaluate the accuracy of ultrasonography and magnetic resonance imaging detection on preoperatively predicting axillary lymph node in breast cancer patients.Methods From August 2010 to February 2011,the clinical data of 293 breast cancer patients underwent preoperative breast ultrasound exam and MRI detection in Ruijin Hospital were analyzed retrospectively.Results In 293 breast cancer patients,3 suffered from bilateral breast cancer.The sensitivity,specificity,negative predictive value and positive predictive value of ultrasound were 60.0％,90.6％,78.0％ and 80.2％,respectively.The sensitivity,specificity,negative predictive value and positive predictive value of MRI test were 50.5％,90.8％,74.0％ and 77.9％,respectively.There was no significant difference between ultrasound and MRI test in these four indices (P ＞ 0.05).No significant difference on accuracy and predictive value was seen in subgroup analysis according to tumor size,tumor grade,hormone receptor and HER2 status between the two examinations.The sensitivity and specificity of ultrasound associated with MRI test were 70.6％ and 97.2％.Conclusions The accuracy and predictive value between preoperative ultrasound exam and MRI is comparable.Ultrasound associated with MRI examination can achieve high specificity,which may spare a portion of patients free from sentinel lymph nodes biopsy.