Preoperative Sonographic Features of Axillary Lymphnodes as Predictors of Malignant Involvement in Biopsy - Proven Breast Cancer?

Introduction

In our hospital’s surgical oncology department, the practice regarding addressing the axilla in breast cancer is to go through a tumour board. For patients planned for upfront surgery and not anterior chemotheapy by the tumour board, broadly clinicoradiologically axilla negative patients receive Sentinel node biopsy ( SLNB)and those who are clinically or radiologically axillary lymph node positive will receive an axillary dissection.

This research was thought of as to determine which imaging characteristics of axillary lymph nodes should be considered as high chance of being metastatic to decide on if SLNB or axillary dissection should be performed upfront.

Materials and Methods

All patients with biopsy-proven invasive breast cancer who are decided for upfront surgery in the tumour board are considered for the study.  Written informed consent in the regional language was obtained from each patient regarding enrollment in the study.  An axillary ultrasound is done a day prior to surgery for all consented patients. The ultrasound features are documented in profomas. Surgery is completed, and the axilla is addressed in the existing manner of the hospital.  A clinicoradiological negative axilla undergoes SLNB, and a positive one axillary dissection.

After the trial,  final histopathology is correlated with the ultrasound characteristics to see which are the best predictive USG characteristics in nodal involvement of breast cancer.