eISSN: 1897-4309
ISSN: 1428-2526
Contemporary Oncology/Współczesna Onkologia
Current issue Archive Manuscripts accepted About the journal Supplements Addendum Special Issues Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
vol. 22
Original paper

Analysis of the causes of false negative and false positive results of preoperative axillary ultrasound in patients with early breast cancer – a single-centre study

Tomasz Nowikiewicz, Adam Nowak, Magdalena Wiśniewska, Michał Wiśniewski, Magdalena Nowikiewicz, Wojciech Zegarski

Contemp Oncol (Pozn) 2018; 22 (4): 247-251
Online publish date: 2018/12/31
View full text
Get citation
JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero
Properly planned and performed diagnostic tests allow the optimal treatment option to be chosen for the patient. They also allow qualification for the correct surgical procedure.

Aim of the study
In this study we evaluated the clinical value of preoperative ultrasound scan (USS) testing performed during primary disease staging in patients with early breast cancer qualified to sentinel lymph node biopsy (SLNB).

Material and methods
The group of breast cancer patients who underwent SLNB from March 2012 to May 2013. As well as the standard procedure of the preoperative diagnostics model, in each patient the USS of axillary lymph nodes was performed additionally. The results were compared with the data from postoperative pathological reports. We attempted to define the factors influencing the possibility of obtaining false positive and false negative USS results.

The analysis comprised 172 patients. In 14.4% of cases with normal USS result the pathological result was different from the expected one (pN1). In 42.3% of patients with suspicious axillary lymph nodes the result of the pathological report was positive. The sensitivity of the USS testing was 89.3%, and the specificity was 34.4%, PPV – 85.6%, NPV – 42.3%.

Ultrasonographic assessment of axillary lymph nodes in breast cancer patients qualified for SLNB is a test with high sensitivity and high predictive value of the positive test result. The possibility of a result contrary to the actual nodal status may result primarily from the technical limitations of USS testing.


breast cancer, ultrasonography, sensitivity, specificity, conserving treatment, sentinel node

Didkowska J, Wojciechowska U. Nowotwory piersi w Polsce i Europie – populacyjny punkt widzenia. Nowotwory J Oncol 2013; 63: 111-118.
Wojtyś P, Godlewski D, Antczak A. Predictions of cancer incidence in Poland in 2019. Cent Eur J Med 2013; 8: 185-191.
Herman K, Śliwczyński A, Wysocki W. Wyniki, metody i koszty leczenia raka piersi w Polsce (w latach 2005-2007). Nowotwory J Oncol 2014; 64: 33-39.
Nowikiewicz T, Zegarski W, Piatkowska M, Klag M. Evaluation of the effects of mammography screening program on cancer progression and implemented treatment in patients with breast cancer. Pol Przegl Chir 2013; 85: 204-209.
Głowacka I, Nowikiewicz T, Hagner W, Nowacka K, Sowa M, Zegarski W. Sagittal Plane Postural Changes in Female Patients with Breast Cancer after Different Surgical Techniques. Breast J 2017; 23: 109-111.
Głowacka-Mrotek I, Sowa M, Siedlecki Z, Nowikiewicz T, Zegarski W. Evaluation of changes to foot shape in females 5 years after mastectomy – case-control study. Breast Cancer Res Treat 2017; 163: 287-294.
Gruber I, Hahn M, Fehm T, Hann von Weyhern C, Stäbler A, Winckelmann A, Wallwiener D, Kühn T. Relevance and methods of interventional breast sonography in preoperative axillary lymph node staging. Ultraschall Med 2012; 33: 337-343.
Lee MC, Joh JE, Chau A. Axillary staging prior to neoadjuvant chemotherapy: the roles of sentinel lymph node biopsy and axillary ultrasonography. Cancer Control 2012; 19: 277-285.
Koehler KE, Ohlinger R. Sensitivity and specificity of preoperative ultrasonography for diagnosing nodal metastases in patients with breast cancer. Ultraschall Med 2011; 32: 393-399.
Ciatto S, Brancato B, Risso G, Ambrogetti D, Bulgaresi P, Maddau C, Turco P, Houssami N. Accuracy of fine needle aspiration cytology (FNAC) of axillary lymph nodes as a triage test in breast cancer staging. Breast Cancer Res Treat 2007; 103: 85-91.
Genta F, Zanon E, Camanni M, Deltetto F, Drogo M, Gallo R, Gilardi C. Cost/accuracy ratio analysis in breast cancer patients undergoing ultrasound-guided fine-needle aspiration cytology, sentinel node biopsy, and frozen section of node. World J Surg 2007; 31: 1155-1163.
Garcia-Ortega MJ, Benito MA, Vahamonde EF, Torres PR, Velasco AB, Paredes MM. Pretreatment axillary ultrasonography and core biopsy in patients with suspected breast cancer: diagnostic accuracy and impact on management. Eur J Radiol 2011; 79: 64-72.
Moon HJ, Jung I, Park SJ, Kim MJ, Youk JH, Kim EK. Comparison of Cancer Yields and Diagnostic Performance of Screening Mammography vs. Supplemental Screening Ultrasound in 4394 Women with Average Risk for Breast Cancer. Ultraschall Med 2015; 36: 255-263.
Keränen AK, Haapea M, Rissanen T. Ultrasonography as a Guiding Method in Breast Micro-Calcification Vacuum-Assisted Biopsies. Ultraschall Med 2016; 37: 497-502.
Mueller-Schimpfle MP, Brandenbusch VC, Degenhardt F, Duda V, Madjar H, Mundinger A, Rathmann R, Hahn M. The Problem of Mammographic Breast Density – The Position of the DEGUM Working Group on Breast Ultrasound. Ultraschall Med 2016; 37: 170-175.
Nowikiewicz T, Nowak A, Wisniewska M, Wiśniewski M, Zegarski W. Diagnostic value of preoperative axillary lymph node ultrasound assessment in patients with breast cancer qualified for sentinel lymph node biopsy. Wideochir Inne Tech Maloinwazyjne 2015; 10: 170-177.
Pinheiro DJ, Elias S, Nazario AC. Axillary lymph nodes in breast cancer patients: sonographic evaluation. Radiol Bras 2014; 47: 240-244.
Perhavec A, Besic N, Hocevar M, Zgajnar J. Touch imprint cytology of the sentinel lymph nodes might not be indicated in early breast cancer patients with ultrasonically uninvolved axillary lymph nodes. Ann Surg Oncol 2008; 15: 2257-2262.
Johnson S, Brown S, Porter G, Steel J, Paisley K, Watkins R, Holgate C. Staging primary breast cancer. Are there tumour pathological features that correlate with a false-negative axillary ultrasound? Clin Radiol 2011; 66: 497-499.
Diepstraten SC, Sever AR, Buckens CF, Veldhuis WB, van Dalen T, van den Bosch MA, Mali WP, Verkooijen HM. Value of preoperative ultrasound-guided axillary lymph node biopsy for preventing completion axillary lymph node dissection in breast cancer: a systematic review and meta-analysis. Ann Surg Oncol 2014; 21: 51-59.
Baruah BP, Goyal A, Young P, Douglas-Jones AG, Mansel RE. Axillary node staging by ultrasonography and fine-needle aspiration cytology in patients with breast cancer. Br J Surg 2010; 97: 680-683.
Gentilini O, Veronesi U. Abandoning sentinel lymph node biopsy in early breast cancer? A new trial in progress at the European Institute of Oncology of Milan (SOUND: Sentinel node vs Observation after axillary UltraSouND). Breast 2012; 21: 678-681.
Quick links
© 2019 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe