New Evaluation of Ultrasonography for Axillary Lymph Node Metastasis in Breast Cancer        LIU Wei, LI Yue, ZHAO Ying, et al.
Corresponding author: WANG Xin, E-mail：xinwangse@126.com
The First Department of Breast Tumor, Tianjin Medical University Cancer Institute and Hospital. Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education; Key Laboratory of Cancer Prevention and Therapy,Tianjin, Tianjin 300060, China
Abstract    Objective    To reduce the postoperative complications of breast cancer and evaluate the value of ultrasonography in detecting ALN metastasis compared with mammography, MRI and PET-CT in patients with breast cancer. Methods   253 breast cancer patients who undergone ultrasonography were studied. The results of the histopathology after surgery were used as diagnostic golden standard. The findings of their sensitivity, specificity, positive predictive value, negative predictive value and accuracy in diagnosing axillary metastases lymph node of breast cancer were compared.  Results    The sensitivity, specificity, positive predictive value, negative predictive value and accuracy obtained by ultrasound were 70.6%, 87.4%, 84.8%, 75.0% and 79.1%. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy obtained by mammography were 14.6%, 100%, 100%, 53.9% and 57.3%. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy obtained by MRI were 50.0%, 100%, 100%, 71.4%, 77.8%. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy obtained by PET-CT were 90.0%, 92.3%, 90.0%, 92.3%, 91.3%. The Kappa value was 0.729. The sensitivity, specificity and accuracy of experienced doctors and un-experienced doctors were 69.2%, 87.1% and 78.1% ; 62.5 %, 88.2% and 75.8% respectively（P<0.05）.  Conclusion Our study indicates that ultrasonography is better than other examinations for predicting axillary node status, moreover the experiences of doctors affect the predicting results.