Abstract:
Objective: To assess the accuracy of ultrasound-guided core biopsy in staging axillary lymph nodes in clinically
node-negative invasive breast cancer patients using histopathology as the gold standard.
Methods: This cross-sectional study was conducted in the Department of Pathology at Mekran Medical College,
Turbat, Pakistan, from April 2023 to September 2023. The study included breast cancer patients who were
clinically negative for lymph node involvement. Ultrasound-guided core biopsies were performed on suspicious
axillary lymph nodes by experienced radiologists, with histopathological analysis serving as the gold standard.
Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were
calculated to assess diagnostic performance. Patient demographics, tumor characteristics, and axillary
ultrasound findings were also recorded.
Results: A total of 132 invasive breast cancer patients were included, with a mean age of 57.67 ± 13.03 years. The
majority of patients were diagnosed with invasive ductal carcinoma, accounting for 113 (85.6%) cases. Hormone
receptor positivity was prevalent, with estrogen receptor positivity in 119 (90.2%) and progesterone receptor
positivity in 116 (87.9%) cases. The most common immunohistochemistry subtype was Luminal B, present in 66
(50%) patients, followed by Luminal A in 51 (38.6%) patients. Most tumors were of moderate grade 77 (58.4%) and
early-stage (pT1) 63 (47.7%). Ultrasound-guided core biopsy exhibited a sensitivity of 87.9% and specificity of 100%,
with positive and negative predictive values of 100% and 89.2% respectively, resulting in a diagnostic accuracy of
93.9%.
Conclusion: Ultrasound-guided core biopsy demonstrates strong diagnostic performance in identifying
metastatic axillary lymph nodes in clinically node-negative invasive breast cancer patients.
