A Prospective Clinical Study to Evaluate the Accuracy of Axillary Lymph Node Staging Using Ultrasound Guided Fine Needle Aspiration Cytology in Breast Cancer Patients

Background: Breast cancer is one of the leading causes of malignant tumours in women. Axillary lymph node involvement has a significant role is staging, survival and management in patients with breast cancer. Axillary lymph node dissection was earlier regarded as a gold standard technique for axillary involvement in breast cancer patients for staging and prognosis. This technique was an invasive procedure with significant morbidity. Ultrasound guided fine needle aspiration is a technique which shows very little morbidity, is cheap and is readily available, which can help in assessment of axillary lymph nodes for its involvement and staging in breast cancer. This study is being undertaken to understand the role of ultrasound guided fine needle aspiration in breast cancer patients for assessment of axillary lymph nodes. Materials and Methods: This prospective study was conducted in the Department of Radiodiagnosis, Rama Medical College Hospital & Research Centre, Kanpur from August 2022 to February 2024. The study was conducted in 50 women with a confirmed diagnosis of breast cancer on HPE with clinical node status of N0 and N1. The collected data was analysed by using SPSS (Statistical Package for Social Sciences) Version 15.0. Result: The study of 50 women showed that the maximum number of breast cancer cases were diagnosed in the ages 52 - 59 with a clinically palpable lump of size 2 - 5cm. On HPE, invasive ductal carcinoma was the most common type of tumour which presented with calcifications of mammography. On ultrasound, level 1 nodes were most commonly affected with malignancy with cortical thickening >3mm. The comparison of accuracy in diagnosis of USG - FNAC and SLNB indicate that the SLNB method yielded total 23 true positive cases, 26 true negative cases, no false positive case, and 1 false negative case, therefore shows sensitivity of 95.83%, specificity of 100.0%, and accuracy of 98.0%. In comparison, the USG - guided FNAC method showed 18 true positive cases, 28 true negative cases, 2 false positive cases, and 2 false negative cases, with a sensitivity of 90%, specificity of 93.3%, and an accuracy of 92%. Conclusion: These results demonstrate that while SLNB has a higher sensitivity, USG - guided FNAC offers slightly better specificity and accuracy.