Use of axillary ultrasonography in breast cancer: a useful tool to reduce sentinel node procedures.

AIM OF THE STUDY: The lymphnode sentinel. method is today used for staging the axillary lymphnode stations. Ultrasonography is widely available and inexpensive method to study axillary status. METHODS: One hundred forteen patients were studied consecutively using axillary ultrasonography and ultrasound guided fine needle aspiration of the lymphnode. We used ATL Ultramark 9 with 5-7,5 MHz multiple frequency linear probe or Aloka SSDD-1400 with 7,5 MHz linear probe. RESULTUS: One hundred forteen patients were examined; six were excluded because of definitive histological diagnosis of non-infiltranting carcinoma. 106 had monofocal carcinomas, 2 had bifocal carcinoma. in 104/108 ultrasonography was carried out successfully. The axillary cytological examination was positive in 18 cases (17.3%) who were subjected to axillary examination. 86 patients were subjected to sentinel lymphnode biopsy positive 13 cases (6 micrometastases). 31 cases/104(29.8%) showed positive axilla. Sensitivity of ultrasonography was 58%, 100% specificity. Predictive positive value 100%, Negative value 84.9% for an accuracy of 87.5%. DISCUSSION: Ultrasonography is useful in all cases eligible to sentinel lymphnode examination; the minimum cost of the procedure and of the human resources is amply rewarded by the direct indication for surgical axillary dissection in case of a positive result (17.3% in our experience).