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Volume 187, Issue 6, Pages 679-683 (June 2004)


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Utility of axillary ultrasound examination to select breast cancer patients suited for optimal sentinel node biopsy

Kazuhiko Sato, M.D.aCorresponding Author Informationemail address, Kuniyoshi Tamaki, M.D.a, Hitoshi Tsuda, M.D., Ph.D.b, Shigeru Kosuda, M.D., Ph.D.c, Shoichi Kusano, M.D., Ph.D.c, Hoshio Hiraide, M.D., Ph.D.d, Hidetaka Mochizuki, M.D., Ph.D.a

Received 13 May 2003; received in revised form 17 October 2003

Abstract 

Background

Because sentinel node (SN) biopsy (SNB) is known to produce false-negative results, we examined the usefulness of axillary ultrasound (AUS) in selecting patients suitable for optimal SNB.

Methods

A positive AUS finding (positive AUS) was defined as an echo pattern of a homogeneously hypoechoic SN without an echo-rich center, indicating massive to extensive nodal involvement. The identification of SNs was performed, and complete axillary dissection was carried out.

Results

A total of 262 women were enrolled into the study (T1 disease = 94; T2 disease = 145; and T3 disease = 23). The incidence of positive AUS increased with increasing size of breast tumor (P <0.0001). The overall identification and false-negative rates were 88.2% and 10.8%, respectively. However, when limited to AUS-negative patients, SNs were identified in 205 of 208 patients (98.6%), and the false-negative rate was 1.7%.

Conclusions

AUS should be included in the preoperative procedure for the selection of breast cancer patients suitable for SNB.

a Department of Surgery I, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan

b Department of Pathology II, National Defense Medical College, Tokorozawa, Saitama, Japan

c Department of Radiology, National Defense Medical College, Tokorozawa, Saitama, Japan

d Research Institute, National Defense Medical College, Tokorozawa, Saitama, Japan

Corresponding Author InformationCorresponding author. Tel.: +81-42-995-1637; fax: +81-42-996-5205

PII: S0002-9610(04)00047-9

doi:10.1016/j.amjsurg.2003.10.012


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