Efficacy of Axillary Ultrasound Pre-Screening in Relation to Pathologic Parameters of Breast Carcinoma
Rebecca J Wolsky, Corey B Bills, Husain Sattar. University of Chicago, Chicago, IL
Background: Axillary lymph node status is the most useful prognostic factor in patients with breast cancer. The current standard of care for screening the axilla is sentinel lymph node biopsy (SLNB). More recently, axillary ultrasound (AUS) with biopsy has become an important pre-screening modality. The purpose of this study is to correlate pathologic features of breast cancer with successful or unsuccessful AUS.
Design: Surgical pathology reports and slides were reviewed from 461 consecutive breast cancer patients (University of Chicago Archive, 2004-2008) who had undergone pre-screening with AUS. These cases were categorized into true positive, false positive, true negative, and false negative based on final nodal status as determined by subsequent SLNB. The cases were then further reviewed to identify pathologic characteristics that were predictive of true negative, false negative, and true positive status.
Results: Both the number of cases in each category along with the relationship to the pathologic parameters is present in Table 1.
|True neg (n=282)||False neg (n=67)||True pos (n=57)||p value|
|Average Tumor size (cm)||1.64||2.55||3.56||<0.0001|
|Number of multifocal cases||45 (16%)||17 (25%)||17 (30%)||<0.05|
|Average number of positive lymph nodes||NA||3.15||5.82||<0.01|
|Average size of largest tumor in lymph node (cm)||NA||0.64||1.65||<0.0001|