PURPOSE

This study was conducted to evaluate the diagnostic accuracy of axillary ultrasound (US) alone or in combination with fine-needle-aspiration cytology (FNAC) in patients with breast carcinoma, in comparison with the final histological examination (sentinel node biopsy and/or axillary dissection).

MATERIALS AND METHODS

Between January 2005 and June 2008, we evaluated 427 breast cancer patients with axillary US. The findings were classified according to the following criteria: hilum and cortex morphology, ratio between longitudinal and transverse diameter and ratio between hilar and longitudinal diameter of the lymph node. Patients with breast lesions <or=3 cm (n=147) underwent FNAC of the most suspicious lymph node.

RESULTS

Overall concordance between axillary US and final histological examination was 85%, sensitivity was 72.3% and specificity was 93.4%. Concordance between FNAC and final histological examination was 93%, sensitivity was 88.1% and specificity was 100%.

CONCLUSIONS

In 48.3% of patients, the combination of axillary US and FNAC guided treatment decisions towards immediate axillary dissection, thus sparing the patients sentinel node biopsy, with a significant reduction of costs and hospitalization time.