The ultrasonographic diagnosis of the axillary lymph nodual metastasis in breast cancer

Objective To investigate the value of the color Doppler ultrasonic diagnosis for metastasis of axillary lymph nodes in breast cancer.Methods The color Doppler ultrasonography was undertaken before pathologic examination to detect axillary metastatic lymph nodes in 266 patients with breast carcinoma.A total of 152 patients with axillary lymph nodes were showed by ultrasonography.They were classified into two groups according to the postoperative pathology of radical mastectomy.One group consisted of all women who had metastasis of axillary lymph nodes;the other had no metastasis of axillary lymph nodes.The ultrasonographic features observed included the maximum dimension,the long-short axis ratio,the cortex-hilum thickness ratio and the flow pattern of axillary lymph nodes on the longitudinal section.The features were analysed univariately to find out the interrelated factors of breast lymph nodes metastasis.The receiver operating characteristic curve(ROC) analysis was done to determine sensitivity and specificity of individual ultrasonographic features in distinguishing metastatic lymph nodes from the healthy one.Results The maximum dimension of axillary lymph nodes in the metastasis group was 18.9±6.7 mm and 19.6± 7.2 mm in the other group.The maximum dimension of lymph nodes was not statistically significant(P 0.05).The long-short axis ratio and the cortex-hilum thickness ratio of axillary lymph nodes of the metastasis group were 1-2.6,0.8-4 and 1-4.5,0.2-2 in the other group.The long-short axis ratio,the cortex-hilum thickness ratio and the flow pattern of axillary lymph nodes of the two groups were statistically significant factors(P 0.05).A total of 54.5%(18/33)of metastatic axillary lymph nodes were peripheral flow and 30.3%(10/33) of metastatic axillary lymph nodes were mixed type flow.And 63.2%(12/19)of metastases axillary lymph nodes were central flow.By ROC analysis,the sensitivity and specificity were 62.4% and 62.7% based on the criteria of the long-short axis ratio ≤1.8,the sensitivity and specificity were 75.3% and 86.4% based on the criteria of the cortex-hilum thickness ratio≥ 1.0.Conclusion It can improve accuracy of the long-short axis ratio ≤1.8 and/or the cortex-hilum thickness ratio≥1.0 for ultrasonic diagnosis for metastasis of axillary lymph nodes in breast cancer.