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Research Article Open access CC BY 4.0

The Sensitivity and Specificity of Preoperative Staging of Axillary Nodes in Cancer Breast Patients

Anshika Arora, Manju Saini, Neena Chauhan, Mayank Bhasin, Sunil Saini

Journal of Cancer and Tumor International · pp. 24–32 · Published 26 Dec 2020

10.9734/jcti/2020/v10i430135

Abstract

Aims: Metastasis to axillary lymph nodes is an important prognostic factor in carcinoma breast patients, with implications on overall survival and progression-free survival. To evaluate the accuracy of pre-operative clinical palpation and USG axilla in patients with carcinoma breast, using histopathology as the gold standard. Study Design: Cross-sectional observational study. Place and Duration of Study: This was a retrospective study, carried out at Cancer Research Institute, SRHU, India, between January 2015 and December 2018. Methodology: Data was collected from Case records and Hospital Information System for patients having undergone surgery for breast cancer. Pre-treatment clinical, ultrasound axilla, and final histopathology details were recorded. Taking histopathology as the gold standard test, diagnostic accuracy of clinical palpation and ultrasound axilla was calculated. Results: 256 patients were enrolled in the study. Clinically, 70.7% of patients were T1/T2 stage, 53.9% were node-positive, on USG axilla 59% had abnormal nodes, pathologically 53.52% had nodal metastasis. The sensitivity, specificity for clinical palpation was 77.86% and 75%, for USG was 90.71% and 79.31%. Sensitivity and specificity of USG in c T1/2 was 88.64% and 80.21%; in c T3/4 94.23% and 65.22%; in c N negative 87% and 72.16%; in c N positive 91.74% and 75.86%. Conclusion: The diagnostic accuracy of clinical palpation of axilla alone was low; Ultrasound axilla had high sensitivity but low specificity across all T stages of breast tumor. The ultrasound had a high negative predictive value in clinically non-palpable nodes and a high positive predictive value in clinically palpable nodes.

Axillary lymph node evaluation axillary ultrasound sensitivity pre-operative axillary evaluation lymph node metastasis in carcinoma breast.

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