Ultrasound detection of metastatic spread to axillary lymph nodes in patients with a suspicious breast lesion

M.Tech. (Radiography)Abstract: The aim of this study is to explore and describe the accuracy of the newly proposed extended set of ultrasound criteria in the detection of metastatic spread to the axillary lymph nodes in patients with a suspicious breast lesion. A quantitative correlational study was performed at a private hospital in Johannesburg. A quota non-probability sampling technique was used and 101 patients with suspicious breast lesions and who were referred for an axillary lymph node dissection and/or sentinel node biopsy were invited to partake in the study. All patients were scanned using a high-tech ultrasound machine with a high frequency transducer. A standard scanning procedure was set up as well as a checklist to ensure all patients were scanned alike. The study sample comprised of only female patients, with the majority being Caucasian and aged between 50-60. The study found that the only biological factors that influenced the metastatic spread was the size of the tumour (>2cm) and the location of the tumour (areolar region), the side of breast as well as the age, gender and ethnicity of the patient has no effect on the metastatic spread. The study found that the conventional ultrasound criteria (>2cm in length, round in shape, loss of fatty hilum and inhomogenous) is accurate in the detection of late stage metastatic disease. However, it is not accurate in early stages of axillary lymph node metastatic disease. The study furthermore confirmed that the size, echogenicity and echotexture were poor predictors of malignancy. With the inclusion of an extended ultrasound criteria (focal cortical thickening ≥3mm and peripheral vascular flow), the research statistics showed positive results with high sensitivity and specificity. Metastatic axillary lymph nodes with a focal cortical thickness ≥3mm had a 92% sensitivity and a p-value of 0.000 whilst, the peripheral vascular pattern..