REGIONAL NODAL STATUS IN CARCINOMA BREAST - CLINICAL, SONOLOGICAL, CYTOLOGICAL AND PATHOLOGICAL CORRELATION

Prof Subbiah Shanmugam; Dr. Bharanidharan; Dr. Rajkiran Thanikachalam

Volume : IX, Issue : VIII, August - 2020

REGIONAL NODAL STATUS IN CARCINOMA BREAST - CLINICAL, SONOLOGICAL, CYTOLOGICAL AND PATHOLOGICAL CORRELATION

Prof Subbiah Shanmugam, Dr. Bharanidharan, Dr. Rajkiran Thanikachalam

Abstract :

Background Time immemorial axillary lymph node status has been established to be the single most important prognostic variable in the management of carcinoma east. The relationship between axillary nodal spread and prognosis depends on the number of nodes involved, the level of the nodes affected, and the extent of disease within the nodes. AIMS AND OBJECTIVES To compare the features of malignant regional ( axillary/ supraclavicular ) nodes by clinical examination, ultrasound examination, and ultrasound-guided fine-needle aspiration cytology of regional nodes with postoperative pathological status in operable carcinoma east. Materials and Methods This is a prospective study on 85 consecutive east cancer patients who underwent clinical examination and presurgical axillary region ultrasound before surgery from august 2017 until December 2019. All operable carcinoma east patients were included in the study and results were reviewed with definitive histopathology after surgery. Results Eighty-five cases were included in the analysis, of which thirty-three had evidence of metastatic nodal involvement at final histology. Of these 33 cases, ultrasound findings for 23 cases were positive. The overall positive predictive value of ultrasound for detecting metastatic nodal involvement measured 0.73. The negative predictive value was 0.83. The sensitivity was 71%; specificity 79%; and accuracy 80%. The ultrasound morphologic lymph node features with the greatest correlation with malignancy was the absence of a hyperechoic hilum (p = 0.0001). Conclusion Even though sonography cannot be used in isolation as a method for deciding whether to perform axillary lymph node dissection, high-frequency axillary USG as part of clinical examination in N0 and N+ patients will be definitely useful along with sentinel node biopsy in avoiding axillary dissection and thereby its complication.