Evaluation of CT scan accuracy in prediction of axillary lymph node metastasis in breast cancer

Introduction: Assessment of axillary metastasis in breast cancer is of vital importance. Sentinel lymph node biopsy, an invasive procedure, is currently considered as the routine method for evaluating axillary lymph node metastasis. In this study, we aim to evaluate CT scanning of the chest as an alternative non-invasive procedure for determining the extent of axillary involvement in breast cancer patients. Methods: This study was designed as a non-randomized, single blind, multicentric diagnostic clinical trial. Fifty breast cancer patients referred to Imam Reza and Ghaem hospitals in 2015 and 2016 were enrolled in the study. For all the candidates of sentinel lymph node biopsy (SLNB), thoracic CT scan with and without IV contrast was carried out prior to the surgery. Inclusion criteria encompassed all the indications for SLNB (lack of axillary lymphadenopathy no history of previous surgery on the axilla), and the possibility of performing CT scanning. The results of CT scan were compared to SLNB. Analysis was  performed using SPSS software version 16, and the sensitivity, specificity, positive and negative predictive values, and accuracy were calculated. Results: Considering lymph nodes with diameters ≥1 cm in CT scan, lymph node central fat absence, and the presence of pathologic lymphadenopathy yielded a sensitivity of 57.1-64.3%, a specificity of 51.7-55.2%, and an accuracy of 55.8%. Conclusion: CT scanning of the axilla does not have any superiority SLNB in axillary lymph node metastasis for breast cancer, and cannot be suggested as an appropriate alternative for this procedure.

کلیدواژه ها:

Breast Neoplasms ، Tomography ، X-Ray Computed ، Sentinel Lymph Node Biopsy ، Lymphatic Metastasis ، Axilla