Aslan Ozge, Oktay Aysenur, Goktepe Berk, Serin Gurdeniz
Department of Radiology, Ege University Faculty of Medicine, Ege University Hospital, Bornova, İzmir, Turkey.
Department of General Surgery, Ege University Faculty of Medicine, Ege University Hospital, Bornova, İzmir, Turkey.
Sci Rep. 2025 Jan 3;15(1):611. doi: 10.1038/s41598-024-84827-w.
This study aimed to evaluate the diagnostic accuracy of ultrasonography in assessing the response of clipped axillary lymph nodes to neoadjuvant chemotherapy. Between February 2022 and September 2023, 43 patients who underwent axillary lymph node marking for targeted axillary dissection were retrospectively analyzed. Ultrasonography parameters such as the number, size, shape, cortical thickness, hilum status, and treatment response of the clipped lymph node were assessed. Post-surgery pathology results served as the gold standard. Ultrasonography revealed 70% complete and 30% partial response, while pathology results showed 51% complete response, 9% micro-metastases, and 40% macro-metastases. The diagnostic accuracy of ultrasonography was 81.4%, with 61.9% sensitivity and 100% specificity. A significant correlation was found between clipped node response in ultrasound and pathology. Additionally, a notable association was observed between clipped node response on ultrasonography, molecular subtype of the breast mass, and the mass's response to NAC. Assessing the treatment response of clipped lymph nodes with preoperative ultrasound, followed by surgical excision using needle wire localization, can be a viable alternative to axillary dissection, offering low false-negative rates.
本研究旨在评估超声检查在评估夹闭腋窝淋巴结对新辅助化疗反应方面的诊断准确性。回顾性分析了2022年2月至2023年9月期间43例行腋窝淋巴结标记以进行靶向腋窝清扫术的患者。评估了夹闭淋巴结的超声参数，如数量、大小、形状、皮质厚度、门部情况及治疗反应。术后病理结果作为金标准。超声检查显示70%完全缓解和30%部分缓解，而病理结果显示51%完全缓解、9%微转移和40%宏转移。超声检查的诊断准确性为81.4%，敏感性为61.9%，特异性为100%。超声和病理检查中夹闭淋巴结的反应之间存在显著相关性。此外，在超声检查中夹闭淋巴结的反应、乳腺肿块的分子亚型与肿块对新辅助化疗的反应之间观察到显著关联。术前使用超声评估夹闭淋巴结的治疗反应，随后采用针丝定位进行手术切除，可作为腋窝清扫术的一种可行替代方案，假阴性率较低。
