Correlation of the use of axillary ultrasound and lymph node needle biopsy with surgical lymph node pathology in patients with invasive breast cancer

BACKGROUND: Results vary regarding the utility of perioperative axillary ultrasound (AUS) and biopsy for detecting axillary metastases. METHODS: Patients diagnosed with invasive breast cancer from 2004 through 2005 who underwent preoperative AUS with or without biopsy, and their surgical pathologic findings were reviewed. RESULTS: Of 152 patients who underwent preoperative AUS, 38% had abnormal AUS findings. Sixty-two percent of biopsy specimens were positive. The sensitivity of AUS both with and without biopsy was 54%, and specificity was 96%. The positive. predictive value was 91%, and the negative predictive value was 71%. CONCLUSIONS: Our results correlate favorably with published reports of preoperative AUS. Standardization of AUS report descriptors is needed. Preoperative AUS should be included in the preoperative workup of clinically node-negative patients. A positive biopsy specimen decreases the need for a sentinel lymph node biopsy specimen; however, a negative AUS result or biopsy specimen does not replace the need to obtain a sentinel lymph node biopsy specimen. (C) 2008 Elsevier Inc. All rights reserved.