Clinical and radiological assessment of axilla in carcinoma breast.

Background/aim: Breast cancer is the leading cause of death from cancer for women in age group of 20-59 years. It is responsible for 15% of the cancer related deaths in women. Our study attempts to assess the axillary lymph node status in carcinoma breast using combined clinical and radiological examination. Materials and methods: A prospective study was conducted using 82 patients with proven cases of carcinoma breast over a period of 2 years. Patients were subjected to clinical examination and ultrasonography of axilla. Then the histopathological reports of the axillary lymph nodes were studied following surgery. The accuracy of clinical and radiological examination have been assessed with the histopathological reports of the lymph nodes. Results: It was noted that clinical examination has a sensitivity of 53.52% and specificity of 100% in detecting axillary lymph node metastasis, with a PPV of 100%, NPV of 25%, chi square value of 10.792 and a p -value of 0.001 which is statistically significant. However, ultrasonography of axilla has a sensitivity of 77.46% and specificity of 100% in detecting lymph node metastasis, with a PPV of 100%, NPV of 40.74%, chi square value of 25.879 and a p-value of 0.001 which is statistically significant. Conclusion: Ultasonography is a non invasive, safe, easily available, less expensive and a reliable method of assessing the lymphatic spread of carcinoma breast to the axilla. Axillary lymph node status assessment is an important step in staging and management of carcinoma breast. In our study, it is highly specific and has got good sensitivity. Further studies have to be conducted on a larger scale to set axillary ultrasound as the standard investigation in assessing the axillary nodal involvement in carcinoma breast. [ABSTRACT FROM AUTHOR]