Rezkallah Emad Mofid Nassif, Elsaify Andrew, Tin Su Min Min, Elsaify Wael
Department of General Surgery, James Cook University Hospital, Middlesbrough, UK.
Foundation Doctor, Misr University for Science and Technology, Giza, Egypt.
J Med Ultrasound. 2023 Feb 14;31(4):293-297. doi: 10.4103/jmu.jmu_99_22. eCollection 2023 Oct-Dec.
Breast cancer is the most common malignancy affecting women all over the world and represents 7% of all cancer-related deaths in the UK. One of the most crucial elements in assessing a patient's prognosis and chance of survival with breast cancer is the condition of their axillary lymph nodes. Ultrasonography (US) is now used as a routine preoperative diagnostic tool for pretherapeutic axillary evaluation. The aim of the current study is to investigate the diagnostic accuracy of US in axillary staging in breast cancer patients.
We carried out this retrospective study for all invasive breast cancer patients who had surgery in addition to preoperative axillary staging using US during the period from January 2020 to February 2021. The final histology results were compared with the preoperative US findings to ascertain the sensitivity, specificity, positive predictive value, and negative predictive value of AUS in axillary staging.
One hundred and twenty-eight patients were included in our study. The average age of diagnosis was 63.9 ± 12.3 years of age. We calculated sensitivity rate of 59.6%, specificity rate of 95.1%, positive predictive value of 87.5%, and negative predictive value of 80.2% with overall diagnostic accuracy of 82.2%.
Despite the important role of preoperative US in axillary staging in breast cancer patients; it failed to detect metastatic diseases in 14.8% of our patients. These findings necessitate the routine histological evaluation of the axilla for more accurate staging of the disease.
乳腺癌是全球影响女性的最常见恶性肿瘤，在英国占所有癌症相关死亡的7%。评估乳腺癌患者预后和生存机会的最关键因素之一是其腋窝淋巴结状况。超声检查（US）现在被用作术前对腋窝进行治疗前评估的常规诊断工具。本研究的目的是调查超声检查在乳腺癌患者腋窝分期中的诊断准确性。
我们对2020年1月至2021年2月期间接受手术且术前使用超声对腋窝进行分期的所有浸润性乳腺癌患者进行了这项回顾性研究。将最终组织学结果与术前超声检查结果进行比较，以确定超声检查在腋窝分期中的敏感性、特异性、阳性预测值和阴性预测值。
我们的研究纳入了128例患者。诊断时的平均年龄为63.9±12.3岁。我们计算出敏感性率为59.6%，特异性率为95.1%，阳性预测值为87.5%，阴性预测值为80.2%，总体诊断准确性为82.2%。
尽管术前超声检查在乳腺癌患者腋窝分期中具有重要作用；但它未能在我们14.8%的患者中检测到转移性疾病。这些发现使得有必要对腋窝进行常规组织学评估，以更准确地对疾病进行分期。
