Ultrasound and Color Doppler Evaluation of Axillary Lymph Nodes in Breast Carcinoma with Histopathological Correlation
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 5, Issue 10
Abstract
Introduction: Accurate assessment of the axillary lymph node status and identifying metastatic changes is extremely important in the management of breast cancer. Aims and Objectives: The aims of this study are to assess the role of ultrasound and color Doppler in diagnosing metastasis to axillary lymph nodes in patients with breast cancer and to correlate with histopathological findings. Materials and Methods: In this prospective study, 62 female patients of biopsy-proven breast cancer were evaluated by high-resolution ultrasonography (USG) and color Doppler in the Department of Radiodiagnosis, NSCB Medical College, Jabalpur, from March 2016 to March 2017, with 5–10 MHz linear transducer. Lymph nodes were assessed using gray-scale and color Doppler parameters such as nodal size, shape, L/S ratio, border, hilum, echotexture, necrosis, matting, and angioarchitecture. A provisional diagnosis was suggested after the ultrasound examination, and these findings were correlated with the tissue diagnosis obtained on subsequent axillary dissection specimen. Results: In our study of 62 cases, 39 patients had metastasis in axillary lymph nodes. Lymph node with oval shape (L/S ratio >2), echogenic hilum, homogenous echotexture, and hilar vascularity was considered as significant parameters in detecting non-metastatic (reactive) lymph nodes. Lymph nodes number ≥3, long axis/short axis ratio <1.4, resistivity index >0.7, pulsatility index >1.4, and non-hilar cortical blood flow were most reliable parameters for diagnosing metastatic lymph nodes with a diagnostic accuracy of 75.80%, 69.35%, 79%, 72.58%, and 85.48%, respectively. Conclusion: This study concludes that USG examination proved as a valuable primary investigation to identify lymph nodes and differentiate non-metastatic and metastatic lymphadenopathy.
Authors and Affiliations
Jyoti Choudhary, Rekha Agrawal, Arpan Mishra, Radhika Nandwani
Keywords
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