Multiparametric Ultrasound Evaluation of Axillary Lymph Nodes in Breast Cancer Patients
Journal of Uludag University Medical Faculty, vol.52, 2026 (Scopus)
- Publication Type: Article / Article
- Volume: 52
- Publication Date: 2026
- Doi Number: 10.32708/uutfd.1906063
- Journal Name: Journal of Uludag University Medical Faculty
- Journal Indexes: Scopus
- Keywords: Axillary lymph node, Breast cancer, Multiparametric ultrasound, Shear wave elastography (SWE), superb microvascular imaging (SMI)
- Open Archive Collection: AVESIS Open Access Collection
- Bursa Uludag University Affiliated: Yes
Abstract
This study aims to evaluate benign and malignant axillary lymph nodes (LN) in breast cancer using multiparametric ultrasound (US). The morphological characteristics, stiffness, and VI differences between 52 benign and malignant LNs were statistically evaluated using B-mode US, shear wave elastography (SWE), and superb microvascular imaging (SMI) before biopsy. Significant cutoff values were determined using receiver operating characteristic (ROC) curve analysis. Malignant lymph nodes had higher short-axis diameters (SD), lower long-axis diameter/short axis diameter ratios (LD/SD), and increased cortical thickness (p=0.026, p=0.044, p=0.004, p=0.000, respectively). A cortical thickness above 3.1 mm (AUC: 0.751, sensitivity: 94.1%, specificity: 51.4%, p=0.0003), SD greater than 8.4 mm (AUC: 0.692, sensitivity: 41.1%, specificity: 91.4%, p= 0.0141), LD/SD ≤2 (AUC: 0.664, sensitivity: 76.5%, specificity: 48.6%, p=0.0355) and, a mean elasticity value above 26.2 kPa (AUC: 0.861, sensitivity: 70.6%, specificity: 91.4%, p<0.0001) were identified as the best cutoff values for detecting metastasis. Since multiparametric ultrasound provides valuable information for detecting metastatic lymph nodes, we recommend multiparametric assessment rather than B-mode ultrasound alone.