Detection of axillary lymph nodes in preoperative study of breast cancer

Objective: To establish the most efficient technique for preoperative diagnosis of positive axillary lymph nodes in patients with breast cancer. Material and methods: Retrospective study of patients with breast cancer who were operated in the Hospital del Mar during 2008, and where the axillary evaluation was established with clinical exploration, ultrasound scan and/or MRI. 90 patients were included. Pathological results of nodes were taken as reference to calculate the sensibility and specificity of each exploration. Results: Sensibility for clinical exploration was 50%, for ultrasound scan 35% and for MRI was 62,5%. Specificity for clinical exploration was 85%, for ultrasound scan was 35% and for MRI was 91%. In cases with just one node affected by metastasis, the sensibility of the clinical exploration was 0%, the sensibility of ultrasound scan was 16% and the sensibility of the MRI was 4%. In cases with more than one affected node, the sensibility of the clinical exploration was 83%, the sensibility of ultrasound scan was 85% and the sensibility of the MRI was 100%. Conclusion: MRI is the most efficient method for preoperative diagnosis of axillary lymph node metastasis. The sensibility of the explorations increases in cases with more than one node affected.