Background: Neoadjuvant chemotherapy (NAC) is frequently used to treat locally advanced breast cancer, which has a substantial impact in eliminating axillary lymph node (LN) metastases. Axillary ultrasound is one of the essential tools for assessing its status, determining axillary management, and guiding the selection of surgical options.
Aim of the Work: is to assess the role of ultrasound in predicting pathologic response of axillary LNs in breast cancer patients after NAC.
Patients and Methods: This study is a retrospective study conducted on 46 cases diagnosed with breast cancer and positive axillary LNs who received NAC and subsequent surgery.
Results: Among 46 breast cancer cases, the mean age was 45.26 years. Comparing pre and post NAC treatment, there was statistically significant difference (p=0.004) as the mean of mass size was 3.46 (range, 1.5–7.5cm) had decreased to 2.75 (range, 0.7–7.5 cm). Post NAC, infiltrated LNS were in 27 cases, and free LNs detected in 19 cases based on the pathological findings, while US reported suspicious LNs “positive" in 25 cases and negative results in 21 cases. The ultrasound and nodal pathology reports were concordant in (82.6%) women .The accuracy, sensitivity, and specificity of axillary ultrasound were 82%, 81.4% and 84% respectively.
Conclusion: Ultrasound proved useful to predict the axillary response to NAC in breast cancer patients. However, it may overestimate or underestimate residual disease in some patients. So, it is strongly recommended to combine two or more radiological modalities to increase the accuracy of final diagnosis in doubtful cases.