Staging primary breast cancer. Are there tumour pathological features that correlate with a false-negative axillary ultrasound?

Sensitivity, Specificity and Accuracy of Ultrasound in Diagnosis of Breast Cancer Metastasis to the Axillary Lymph Nodes in Chinese Patients

“…A previous retrospective study by Park et al (2013) indicated that ER and PR positivity were strongly correlated with the high false-negative rate. In contrast, Johnson et al (2011) reported that there were no statistically significant differences in false-negative ultrasound results with respect to ER/PR status. To our knowledge, no study has been conducted on the relationship of HER-2, p53 and Ki-67 with the false-negative ultrasound rate.…”

“…Their finding indicates that ultrasound has moderate sensitivity, but high specificity in the detection of axillary metastases. However, other studies have reported on the impact of false-negative results in preoperative axillary ultrasound (Choi et al 2012;Johnson et al 2011;Neal et al 2010;Park et al 2013) on prognosis and choice of surgery. Thus, in this study, we assessed the diagnostic value of ultrasound imaging in the detection of breast cancer metastases to the axillary lymph nodes.…”

Pre-operative Ultrasonographic Evaluation of Axillary Lymph Nodes in Breast Cancer Patients: For Which Group Still of Additional Value and in Which Group Cause for Special Attention?

“…Lobular histology and PR positivity were more often observed within this subgroup, although these factors did not remain significant after multivariate analysis. In the literature, the percentages of falsenegative US and FNAC range between 28.1% and 31% (Johnson et al 2011;Leenders et al 2012Leenders et al , 2013. These patients were younger, had larger tumors, had tumors that were lobular (although not always significant) and had lymph vascular invasion (Choi et al 2012;Johnson et al 2011;Leenders et al 2013).…”

“…The reasons are not always clear. Johnson et al (2011) state that a falsenegative US is more likely in larger tumors and tumors with lymph vascular invasion because of the higher pretest probability of metastatic disease. The correlation of ER positive tumors and false-negativity is unknown.…”

Normal Axillary Ultrasound Excludes Heavy Nodal Disease Burden in Patients with Breast Cancer

“…[13][14][15][16] Characteristics associated with false-negative AUS in these studies have included invasive lobular carcinoma, larger tumor size, palpability or multifocality of primary tumor, and lymphovascular invasion (Table 4). [13][14][15] Two studies failing to show an association between lobular carcinoma and falsenegative AUS had very few lobular carcinomas. 13,16 Lack of power may account for this difference from the present study.…”