Correlation of the use of axillary ultrasound and lymph node needle biopsy with surgical lymph node pathology in patients with invasive breast cancer

Background Results vary regarding the utility of perioperative axillary ultrasound (AUS) and biopsy for detecting axillary metastases. Methods Patients diagnosed with invasive breast cancer from 2004 through 2005 who underwent preoperative AUS with or without biopsy, and their surgical pathologic findings were reviewed. Results Of 152 patients who underwent preoperative AUS, 38% had abnormal AUS findings. Sixty-two percent of biopsy specimens were positive. The sensitivity of AUS both with and without biopsy was 54%, and specificity was 96%. The positive predictive value was 91%, and the negative predictive value was 71%. Conclusions Our results correlate favorably with published reports of preoperative AUS. Standardization of AUS report descriptors is needed. Preoperative AUS should be included in the preoperative workup of clinically node-negative patients. A positive biopsy specimen decreases the need for a sentinel lymph node biopsy specimen; however, a negative AUS result or biopsy specimen does not replace the need to obtain a sentinel lymph node biopsy specimen.