Evaluation of efficacy of USG and USG guided FNAC of axillary lymph node of carcinoma breast in clinically node negative cases
Yedin Chandra, KV Chidananda
Background: Breast carcinoma is the most common cancer in the women of developed countries. In India, it accounts for 25-30% of all cancer in women. The average age of developing cancer is shifted from 50-70 years to 30 to 50 years. In the absence of distant metastasis, assessment of axillary lymph nodes is the most important component of initial staging process and the presence or absence of axillary metastasis is the strongest prognostic factor for carcinoma breast due to its impact on the subsequent management. Cancer in the young is found to be more aggressive as compared to older age group. Objectives: To find out the efficacy of ultrasound and ultrasound guided FNAC of axillary lymph node of carcinoma breast and evaluation of axillary metastasis in clinically node negative cases.Methods: This was a comparative study done at a rural tertiary care centre from November 2018 to November 2020. All the patients with clinically node negative carcinoma breasts were evaluated with USG Axilla and those found to be having lymph nodes were subjected to USG guided FNAC and these were correlated with the Histopathology report.Results: 24 patients who satisfied the inclusion criteria were included in study. The most common age group involved in this study was 35-45 years. The most common location of the lump was found to be upper outer quadrant. The sensitivity of the USG in detecting axillary lymph node was 50%, specificity 75%, positive predictor value 80%, negative predictor value 42.8% and accuracy of 58.3%. Sensitivity of USG guided FNAC was 50%, specificity 100%, positive predictor value 100%, negative predictor value 50% and accuracy of 66.6%.Conclusion: This study concluded that USG-FNAC of axillary lymph node is a simple, minimally invasive and reliable diagnostic approach for the initial staging of axillary lymph node status in patients with carcinoma breast. The PPV of 100% and NPV of 50% indicate that the predictor power of a positive result is excellent but nevertheless a negative result is less helpful. High sensitivity and specificity and relatively low false negative rate of USG and guided FNAC of non-palpable axillary lymph nodes indicates that it is immensely valuable in planning the appropriate management of patients.