Comparison of MRI and Ultrasound for Evaluation of Axillary Lymph Node Status in Early Breast Cancer

This study aimed to compare the diagnostic accuracy of ultrasound (US) and magnetic resonance imaging (MRI) in evaluating axillary lymph nodes (ALNs) status in breast cancer patients.

We retrospectively analyzed 590 female breast cancer patients who had undergone both ultrasound and MRI to assess ALNs prior to any invasive procedures. Using pathological results as the standard, we compared the diagnostic performance of the two imaging modalities.

For differentiating between malignancy and benign ALNs, the diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of ultrasound were 68.98%, 38.14%, 86.67%, 62.12% and 70.96%, respectively. MRI demonstrated corresponding values of 72.03%, 38.60%, 91.20%, 71.55% and 72.15%. In assessing the burden status of ALNs (high vs low), ultrasound yielded values of 78.47%, 52.75%, 83.17%, 36.36% and 90.61%, while MRI showed corresponding values of 81.19%, 52.75%, 86.37%, 41.38% and 90.93%. There were no statistically significant differences between the two imaging modalities in their ability to evaluate ALN malignancy or burden status.

Both ultrasound and MRI offer comparable value in assessing ALN status. Whether evaluating for metastatic involvement or determining ALN burden, it may not be necessary for patients to undergo both imaging tests.