The use of X-ray for lymph node determination in the axillary dissection specimen

A new and simple method by X-ray is described for lymph node determination in the axillary specimen of breast cancer patients. X-rays were performed of the axillary specimens of 49 women with breast cancer. The number of lymph nodes visible on the X-rays were assessed by two radiologists (A and B). The number of nodes identified in the axillary specimens was reported by the pathologist independently. The method described shows a clear correlation between the mean numbers of nodes counted on the X-rays of the specimens (radiologist A 18.3, B 16.1 nodes) and the mean numbers of nodes recovered by the pathologist (18.4). No intra-observer variation was observed and only a small inter-observer variation (2.2 nodes). This method of X-ray determination of lymph nodes can be used in auditing the surgeon's accuracy in performing complete axillary dissection as well as in auditing the number of lymph nodes found by the pathologist.