Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2021, 165(1):64-68 | DOI: 10.5507/bp.2020.005

Association between negative preoperative axillary node staging and surgical sentinel node biopsy in patients with newly diagnosed breast cancer: A retrospective analysis

Lucia Veverkovaa, Bohuslav Melicharb, Nora Zlamalovac, Katherine Vomackovac, Marketa Koleckovad, Rohit Philip Thomase
a Department of Radiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
b Department of Oncology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
c Department of Surgery I, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
d Department of Pathology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
e Department of Diagnostic and Interventional Radiology, UKGM University Hospital Marburg, Philipps University, Marburg, Germany

Aim: The aim of this retrospective study was to analyse the preoperative ultrasound findings in patients with minimal or almost no morphological changes of axillary lymph nodes (LN) and to correlate these findings with the results of sentinel node (SN) biopsy.

Materials and Methods: Between January 2014 and September 2018, 289 female patients with newly diagnosed breast cancer and negative preoperative axillary staging were examined with preoperative ultrasound evaluation of axillary LNs. Patients with no evidence of LN metastases underwent primary surgical treatment with SN biopsy. Negative predictive value (NPV) of preoperative ultrasound was evaluated and the histopathological findings in positive SN biopsies were correlated with tumour type and preoperative ultrasound LN imaging.

Results: Of 289 patients with negative preoperative axillary staging who had primary surgical treatment, 268 patients had negative SN biopsy while SN metastases were detected in 21 patients. Of patients with positive SN biopsies, 2 patients had negative core biopsy of axillary LN before surgery. The preoperative ultrasound examination was negative in the remaining 19 patients with SN metastases.

Conclusions: Preoperative ultrasonography is very accurate in the detecting of axillary LN metastases. Patients with primary tumour size ≥ 1 cm, with grade ≥ 2 no special type carcinomas (NST - no special type, also known as invasive ductal carcinoma) or multicentric lobular invasive cancer should undergo a more thorough ultrasound evaluation.

Keywords: breast cancer, sentinel node biopsy, ultrasound, axillary staging

Received: October 22, 2019; Revised: January 28, 2020; Accepted: January 29, 2020; Prepublished online: February 25, 2020; Published: March 12, 2021  Show citation

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Veverkova, L., Melichar, B., Zlamalova, N., Vomackova, K., Koleckova, M., & Thomas, R.P. (2021). Association between negative preoperative axillary node staging and surgical sentinel node biopsy in patients with newly diagnosed breast cancer: A retrospective analysis. Biomedical papers, 165(1), 64-68. doi: 10.5507/bp.2020.005
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