A comparative study to evaluate the efficacy of the USG and USG guided FNAC of axillary lymph node of carcinoma breast in clinically node negative cases

Ramesh H., Praveen K. N., Akshay V. Gokak, Abhijit D. H.


Background: Breast cancer remains the most common malignancy among women and accounts for 32% of all cancers in women. The average age of developing cancer is shifted from 50-70 years to 30-50 years. Cancers in young tend to be more aggressive. In the absence of distant metastasis, assessment of axillary status is the important part of initial staging process because of its subsequent importance in management. And the absence of presence or absence of axillary metastasis is the strongest prognostic indicator available for breast carcinoma. The objectives were to assess the accuracy USG and USG guided FNAC of axillary lymph nodes of carcinoma breasts in clinically node negative cases and to determine USG guided FNAC can be used to detect axillary lymph nodes metastasis.

Methods: This was a comparative study conducted at KIMS Hospital from November 2013 to November 2015. All the patients with clinically node negative carcinoma breasts were evaluated with USG Axilla and those found to be having lymph nodes were subjected to USG guided FNAC and these were correlated with the HPR report.

Results: A total 12 patients who satisfied the inclusion criteria were included in study. The most common age group involved in this study was 30-40 years. Upper outer quadrant was the most common location of the group. The sensitivity of the USG in detecting axillary lymph node was 50%, specificity 75%, positive predictor value 805, negative predictor value 42.8% and accuracy of 58.3%. Sensitivity of USG guided FNAC was 50%, specificity 100%, positive predictor value 100%, negative predictor value 50% and accuracy of 66.6%.

Conclusions: In conclusion USG-FNAC of axillary lymph node is a simple, minimally invasive and reliable technique for the initial determination of ALN status in patients with breast carcinoma. In present study, the PPV of 100% and NPV of 50% indicate that the predictor power of a positive result is excellent but as expected a negative result is less helpful.


Axillary lymph node, Breast carcinoma, USG guided FNAC

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