DefinePK

Abstract

Objective: This study aimed to evaluate the accuracy of ultrasound scans in determining axillary lymph node status in breast cancer patients.
Methodology: The study was Conducted at the Breast Cancer and Screening Centre in the Department of Radiology at PIMS Hospital, Islamabad, the study followed a descriptive and validation design. After obtaining approval, 113 eligible patients provided complete medical histories and signed informed consent forms. A radiologist performed pre-operative axillary ultrasound scans using a high-frequency transducer, applying pressure as necessary. Doppler analysis was also conducted, and results were recorded on a checklist. The contralateral axilla was examined for lymph nodes as a control. Results were compared with histopathology reports to evaluate sensitivity, specificity, positive predictive value, and negative predictive value of axillary ultrasound. Data were analyzed using SPSS.
Results: The mean patient age was 55.38±6.78 years. Axillary ultrasound indicated axillary metastasis in 62.2% of patients, while Doppler ultrasound showed 54.9%. Histopathology revealed axillary metastasis in 48.7% of cases. Diagnostic accuracy of axillary ultrasound was as follows: sensitivity (96.36%), specificity (74.14%), positive  predictive  value  (77.94%),  negative  predictive  value  (95.56%),  and diagnostic accuracy (84.96%). Combined axillary and Doppler ultrasound improved diagnostic  accuracy,  with  sensitivity  (98.18%),  specificity  (86.21%),  positive predictive  value  (87.10%),  negative  predictive  value  (98.04%),  and  diagnostic accuracy  (92.04%)  when  histopathology  was  the  gold  standard.  A  positive correlation (r=0.741, p=0.0001) was observed between axillary ultrasound and histopathology findings.
Conclusion: Axillary ultrasonography is a preferred non-invasive technique for pre- operative diagnosis of axillary metastases in breast cancer patients. Combining axillary and Doppler ultrasound significantly improves diagnostic accuracy. Additional Doppler ultrasound alongside axillary ultrasound is recommended for accurate diagnosis.