The role of ultrasound elastography in evaluation for axillary lymph nodes of patients with breast cancer

Abstract

Axillary lymph node status is the most reliable prognostic indicator for disease recurrence and patient survival in breast cancer. Axillary ultrasound is an important mean for detecting metastatic LNs, being non-invasive, available & cheap. However, the indices, given by these methods and reflecting the benign or malignant lesions, always overlap in large measure, therefore causing difficulties in differentiation. US-guided fine needle aspiration, core biopsy or excision can be added if suspicious lymph nodes are found. a non-invasive technique is required for precise differentiation between benign and malignant lymph nodes. Elastography is a promising complementary technique to US that may be helpful for differentiating benign and metastatic LNs by measuring tissue elasticity that is not reflected on the conventional sonograms. It utilizes the long-established clinical concept that malignant lesions are often stiffer than normal tissues. Our study aimed at achieving better differentiation between benign and malignant enlarged axillary lymph nodes by Ultrasound elastography as complementary technique to conventional ultrasound. Initially, enlarged axillary lymph nodes were examined by B mode ultrasound for characterization of suspicious criteria such as shape, size, cortical thickness and presence of fatty hilum, but alone, those were not accurate enough to differentiate.