Ling Li,1 Jing Zhao,2 Fangxuan Li,3 Zhanyu Pan1 

1Department of Integrated Traditional and Western Medicine, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People’s Republic of China; 2Department of Ultrasound Diagnosis and Treatment, Tianjin Medical University Cancer Institute & Hospital, Tianjin, People’s Republic of China; 3Department of Cancer prevention, Tianjin Medical University Cancer Institute & Hospital, Tianjin, People’s Republic of China

Correspondence: Zhanyu Pan, Department of Integrated Traditional and Western Medicine Tianjin Medical University Cancer Institute & Hospital, Huanhuxi Road, Hexi District, Tianjin, 300060, People’s Republic of China, Email pzytg1@126.com Fangxuan Li, Department of Cancer Prevention Center, Tianjin Medical University Cancer Institute and Hospital, Binshui Ave, Hexi District, Tianjin, 300060, People’s Republic of China, Email lifangxuan2008@126.com; lifangxuan@tjmuch.com

Introduction: 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.
Methods: 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.
Results: 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.
Conclusion: 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.
Plain Language Summary: 1. Both ultrasound and MRI have shown equally good value in assessing the ALNs status.
2. Whether evaluating for the metastatic ALNs or assessing the burden status of the ALNs, it is unnecessary for patients to undergo both tests.

Keywords: breast cancer, axillary lymph node, ultrasound, magnetic resonance imaging, assessment value