Negative axillary ultrasonography with biopsy may predict non‐involvement of the non‐sentinel lymph nodes in operable breast cancer patients

Aim To evaluate whether axillary ultrasound in combination with a biopsy ( AUS +/− B x) can predict the involvement of the non‐sentinel lymph nodes ( NSLN ). Methods A review of all operable breast cancer patients who underwent AUS +/− B x at our tertiary care center from J anuary 2010 to A pril 2011 was performed. All patients underwent AUS as part of their pre‐operative evaluation. If the AUS was suspicious, a fine‐needle aspiration or core‐needle biopsy was performed. Results Of 88 patients included in our final analysis, 20 (23%) had positive AUS  +  B x and underwent axillary lymph node dissection ( ALND ) at time of definitive surgery. In all, 68 of the 88 patients (77.3%) had negative AUS +/− B x and underwent sentinel lymph node ( SLN ) B x at the time of definitive surgery. If the SLN B x was negative, no further axillary surgery was performed and the NSLN were assumed to be negative. If the SLN B x was positive, ALND was performed. Of the 68 patients, 62 (91%) had a negative NSLN . Patients with positive AUS  +  B x carry a relative risk of 2.02 ( P  < 0.00002) of having positive NSLN . Conclusion In operable breast cancer patients, a negative AUS +/− B x may be a predictor of non‐involvement of the NSLN .