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Can Accurate Pre Operative Assessment of Axillary Lymph Node in Breast Cancer Avoid Axillary Dissection?

run H. Narasannaiah, Assistant Professor, Surgical Oncology Unit, Department of Surgery, Bangalore Medical College and Research Institute, Bangalore Karnataka 560002. , Arun H. Narasannaiah* , Mallikarjun Manangi** , Sheshgiri Rao***

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Indian Journal of Cancer Education and Research 6(1):p 13-17, January-June 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijcer.2321.9815.6118.1

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Background: The Axillary Lymph node status is of paramount importance in staging, treatment planning, prognosis and survival in Breast Cancer. Hence appropriate investigating criteria for AXLN assessment, which is easy, noninvasive, repeatable and accurate method is need of the hour. 

Materials and Methods: All the upfront operable breast cancer were considered for the Study. A detail history, thorough clinical examination was done and all the patients were subjected for Axillary Ultrasound and Mammogram. All the patients underwent Axillary dissection of level 1 and 2 clearence along with Mastectomy or Lumpectomy. The Histopathological finding of axillary lymphnode status is compared with clinical, Sonological and mammographic findings. 

Results: In our study of 120 cases,112 cases underwent Modified Radical Mastectomy and 8 cases Lumpectomy with Axillary Dissection. The sensitivity and specificity of AXLN metastases detected by Clinical examination method is 40.16% and 49.83%. The Ultrasound has high sensitivity of 97.59%, indicating that it identifies all the enlarged lymph nodes harboring the metastases, although the specificity is low 81.08% Mammogram showed sensitivity of 60.32% and specificity of 87.72%. Combination of clinical and ultrasound examination showed improved sensitivity as 0.5 cms size lymphnodes could be detected by sonology.  

Conclusion: The clinical staging of axilla in cancer breast is best done using both clinical and Ultrasound examination, as they complement each other and enhance the accuracy.


Keywords: Axillary Lymph Node; Breast Cancer; Axillary Dissection


 

 

 

 

 

 

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DOI: DOI: http://dx.doi.org/10.21088/ijcer.2321.9815.6118.1

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