DETECTION OF NODAL METASTASIS IN BREAST CANCER PATIENTS: ROLE OF APPARENT DIFFUSION COEFFICIENT RATIO BETWEEN AXILLARY LYMPH NODE AND PRIMARY TUMOR

Background: Breast cancer is the leading type of cancer affecting women across the world thus there is a need to have accurate and efficient diagnostic and staging tools. The present investigation aimed to evaluate the diagnostic performance of the ADC ratio of the axillary Lymph nodes and primary breast tumors for nodal metastasis prediction in breast cancer. Objective: The objective of the study was to evaluate the diagnostic accuracy of the ADC ratio in detecting nodal metastasis in breast cancer patients using MRI. Methods: This case-control study was performed in the radiology department of Combined Military Hospital, Rawalpindi Pakistan. The study involved 66 women who were above 18 years of age with primary breast cancer, planned for surgical treatment, and who had preoperative. MRI exams and ADC measurements of breast cancer patients were analyzed by three senior radiologists to evaluate the ability of the ADC ratio in nodal metastasis detection. The data analysis for this study was conducted in Statistical Package for Social Sciences (SPSS) version 26. Results: The Mean ADC and ADC ratios both were significantly lower in Metastatic axillary Lymph Nodes as compared to Benign lymph nodules. The result of the analysis indicated that there are differences that are statistically significant (P<0.05). Moreover sensitivity, specificity, PPV and NPV at the cut of the value of 1.04 were 89. 87%, 83. 11%, 80. 76%, and 79. 90%, respectively. Conclusions: The study findings indicate that the ADC ratio is a reliable and accurate biomarker for identifying metastatic axillary lymph nodes in breast cancer patients, providing a non-invasive diagnostic alternative with high sensitivity and specificity.