Background Axillary lymph nodes remain an important prognostic factor in patients with breast
cancer. Sensitivity (S) and specificity (SP) of preoperative ultrasound which is used
for axillary staging may be influenced by cancer character.
Methods Retrospective analysis of 232 patients with breast cancer which were screened for
metastatic axillary lymphnodes by ultrasound before the operation between 1st January
2014 an 31 th December 2018. Lymphnodes were assessed as „ not affected“ versus„ suspicious“.Afterwards
either adjuvant sentinel lymphnode biopsy or axillary dissection was performed.
Results Sensitivity of axillary ultrasound varies between intrinsic molecular subtypes: Highest
for triple-negative like breast cancer (tnbc) (sensitivity 87,5%), but lowest for
luminal A like breast cancer (sensitivity :25%) and luminal b HER 2 neu like negative
breast cancer (sensitivity: 54,3%). Specivicity are much narrower ranging between
81,8% for tnbc and 98,7 for luminal A like breast cancer.
Discussion Failing statistic significance in this analysis and facing the disadvantages of retrospective
studies the exact impact of intrinsic molecular subtype on sensitivity and specificity
of axillary ultrasound is still unknown. However this data suggest subtype might influence
axillary staging and therefore might influence therapy decision leading to an over
-or undertreatment.
Conclusion When determining clinical axillary lymph node stage for breast cancer patients doctors
should be aware that intrinsic molecular subtype might have an impact on the accuracy
of axillary ultrasound.
