Prognostic Role of Preoperative Axillary Ultrasound for Lymph Node Metastasis and Recurrence in Early Stage Breast Cancers - Research Article Summary

Q: What was the purpose of the preoperative axillary ultrasound study?

To evaluate whether preoperative axillary ultrasound in early-stage, clinically node-negative breast cancer can predict nodal metastasis and long-term recurrence.

Q: How were patients categorized based on axillary ultrasound findings?

Patients were classified as US-positive if suspicious nodes were present (e.g., cortical thickening or absent fatty hilum) and as US-negative otherwise.

Q: What diagnostic performance did preoperative axillary ultrasound show?

Preoperative axillary US demonstrated sensitivity of 42.4% and specificity of 80.8%, with positive predictive value of 51.3% and negative predictive value of 74.7%.

Sep 29, 2026

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Evaluating preoperative axillary ultrasound (US) for early-stage, clinically node-negative breast cancer, this retrospective study assesses whether US can predict axillary nodal metastasis and long-term recurrence. Patients with T1–T2 clinically node-negative disease underwent preoperative axillary US and surgery in 2009. US-positive classification reflected suspicious sonographic features, and outcomes were analyzed with χ2 testing, Cox regression, and Kaplan–Meier methods. Results show limited sensitivity (42.4%) but higher specificity (80.8%), with US positivity linked to worse recurrence-free survival.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Abstract

Purpose

Methods

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Conclusion

Introduction

Background on lymph node metastasis and prognosis

Evolution of axillary management strategies

J Breast Cancer. 2025 Dec;28(6):393-405 [https://doi.org/10.4048/jbc.2025.0111](https://doi.org/10.4048/jbc.2025.0111)[ ](https://doi.org/10.4048/jbc.2025.0111)pISSN 1738-6756·eISSN 2092-9900 Original Article Received: May 13, 2025 Revised: Jul 21, 2025 Accepted: Sep 9, 2025 Published online: Oct 20, 2025 Correspondence to Eun Young Ko Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea. Email: [claudel@skku.edu](claudel@skku.edu) © The Authors 2025 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([https://](https://)[ ](https://)[creativecommons.org/licenses/by-nc/4.0/](creativecommons.org/licenses/by-nc/4.0/)) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ORCID iDs Han Song Mun [https://orcid.org/0000-0003-4718-1788](https://orcid.org/0000-0003-4718-1788)[ ](https://orcid.org/0000-0003-4718-1788)Eun Young Ko [https://orcid.org/0000-0001-6679-9650](https://orcid.org/0000-0001-6679-9650)[ ](https://orcid.org/0000-0001-6679-9650)[Boo-Kyung Han](Boo-Kyung Han) [https://orcid.org/0000-0003-1896-0571](https://orcid.org/0000-0003-1896-0571)[ ](https://orcid.org/0000-0003-1896-0571)Eun Sook Ko [https://orcid.org/0000-0002-0399-7956](https://orcid.org/0000-0002-0399-7956)[ ](https://orcid.org/0000-0002-0399-7956)Ji Soo Choi [https://orcid.org/0000-0003-1361-5269](https://orcid.org/0000-0003-1361-5269)[ ](https://orcid.org/0000-0003-1361-5269)Sang Hee Kim [https://orcid.org/0009-0005-1107-7200](https://orcid.org/0009-0005-1107-7200) Prognostic Role of Preoperative Axillary Ultrasound for Lymph Node Metastasis and Recurrence in Early Stage Breast Cancers Han Song Mun 1, Eun Young Ko 2, Boo-Kyung Han 2, Eun Sook Ko 2, Ji Soo Choi 2, Sang Hee Kim 2 1Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea 2Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea ABSTRACT Purpose: Evaluating the role of preoperative axillary ultrasound (US) in early-stage, clinically node-negative breast cancer, focusing on its ability to predict nodal metastasis and long-term recurrence. Methods: This retrospective study included patients with T1–T2 clinically node-negative breast cancer who underwent preoperative axillary US and surgery between January and December 2009. Based on US findings, patients were classified as US-positive (presence of suspicious nodes, such as cortical thickening or absent fatty hilum) or US-negative. Clinicopathological features and recurrence outcomes were analyzed using the χ2 test, Cox proportional hazards regression, and Kaplan–Meier survival analysis. Results: Among 878 women (mean age, 49 ± 9 years), 234 were US-positive and 644 were US-negative; 283 patients were pathologic node-positive (pN ≥ 1) and 595 were node-negative (pN0). Preoperative axillary US demonstrated a sensitivity of 42.4%(95% confidence interval [CI], 36.8–48.2); specificity, 80.8%(95% CI, 77.5–83.8); positive predictive value, 51.3%(95% CI, 44.9–57.6); and negative predictive value, 74.7%(95% CI, 71.2–77.9). The US-positive group had a higher rate of axillary lymph node dissection (62.8% vs. 32.8%), greater mean number of metastatic nodes (2.6 vs. 0.5), and higher proportion of macrometastasis (94.2% vs. 71.8%) compared with the US-negative group (all p < 0.001). The 10-year recurrencefree survival was lowest in the pN-positive/US-positive group (90.3%; 95% CI, 82.7–94.7), intermediate in the pN-positive/US-negative group (92.4%; 95% CI, 86.7–95.7), and highest in the pN-negative group (97.4%; 95% CI, 95.4–98.5) (log-rank p < 0.001) . Conclusion: Preoperative axillary US might help a

FAQs

What was the purpose of the preoperative axillary ultrasound study?

To evaluate whether preoperative axillary ultrasound in early-stage, clinically node-negative breast cancer can predict nodal metastasis and long-term recurrence.

How were patients categorized based on axillary ultrasound findings?

Patients were classified as US-positive if suspicious nodes were present (e.g., cortical thickening or absent fatty hilum) and as US-negative otherwise.

What diagnostic performance did preoperative axillary ultrasound show?

Preoperative axillary US demonstrated sensitivity of 42.4% and specificity of 80.8%, with positive predictive value of 51.3% and negative predictive value of 74.7%.

Sep 29, 2026

Uploaded by moss~