Utility of axillary ultrasound examination to select breast cancer patients suited for optimal sentinel node biopsy

Background: Because sentinel node (SN) biopsy (SNB) is known to produce false-negative results, we examined the usefulness of axillary ultrasound (AUS) in selecting patients suitable for optimal SNB. Methods: A positive AUS finding (positive AUS) was defined as an echo pattern of a homogeneously hypoechoic SN without an echo-rich center, indicating massive to extensive nodal involvement. The identification of SNs was performed, and complete axillary dissection was carried out. Results: A total of 262 women were enrolled into the study (T1 disease = 94; T2 disease = 145; and T3 disease 23). The incidence of positive AUS increased with increasing size of breast tumor (P < 0.0001). The overall identification and false-negative rates were 88.2% and 10.8%, respectively. However, when limited to AUS-negative patients, SNs were identified in 205 of 208 patients (98.6%), and the false-negative rate was 1.7%. Conclusions: AUS should be included in the preoperative procedure for the selection of breast cancer patients suitable for SNB. (C) 2004 Excerpta Medica, Inc. All rights reserved.