Added value of ultrasound in screening the clinically negative axilla in breast cancer

Background: For staging purposes in breast cancer it is current practice to perform a sentinel node biopsy in a clinically negative axilla, followed by an axillary lymph node dissection if metastases are found in the sentinel node. To limit the number of surgical procedures it is therefore of importance to try and identify as much patients as possible who have axillary metastases. Clinical staging of the axillary nodes in breast cancer is mainly based on palpation, but ultrasound has been shown to be of additional value in detecting pathological nodes. Methods: In this paper, we report our results of screening 131 breast cancer patients without palpable axillary nodes through ultrasound. Results: Out of the 53 patients with axillary node involvement, 18 were identified as such by our radiologist, resulting in a detection score of 34%. Discussion: This high rate is probably reached because of the limited number of radiologists performing this procedure, thereby rapidly increasing their experience.

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