Sonographic Characteristics of Enlarged Axillary Lymph Node in Breast Cancer

Abstract

Background: Breast cancer, the most prevalent cancer in women globally, presents unique challenges in Pakistan, particularly due to the younger average age of diagnosis compared to Western countries. Accurate assessment of axillary lymph nodes using ultrasound (US) is essential for effective breast cancer staging and prognosis.

Objective: This study aimed to evaluate the sonographic characteristics of axillary lymph nodes in breast cancer patients in Pakistan and to assess the diagnostic efficacy of ultrasound in differentiating between benign and malignant lymph nodes.

Methods: Conducted at Shalamar Hospital, Lahore, this cross-sectional study spanned four months and included 150 breast cancer patients aged 45-70 years, selected through convenient sampling. Ultrasound examinations were performed using a GE Ultrasound Machine Evolsion E7 with a linear probe (7.5-12Hz). Key sonographic parameters, including the shape, size (length and width), and echogenicity of lymph nodes, were meticulously recorded and analyzed by using SPSS 24.0.

Results: The average length and width of lymph nodes were 5.86 mm (SD = 1.35) and 3.90 mm (SD = 0.77), respectively. A significant proportion of lymph nodes (74.2%) presented with a round shape in patients experiencing pain, and a predominance of hyperechoic nodes was noted, diverging from established literature that often associates hypoechoic nodes with malignancy. Additionally, an irregular shape was identified as a potential predictive marker for axillary lymph node metastasis.

Conclusion: This study highlights the efficacy of axillary sonography in diagnosing axillary metastasis in breast cancer, showing moderate sensitivity and substantial specificity. It also identifies a notable association between older age and the likelihood of axillary lymph node metastasis, especially in women in their forties.