Abstract
M.Tech. (Radiography)
The aim of this study is to explore and describe the accuracy of the newly
proposed extended set of ultrasound criteria in the detection of metastatic
spread to the axillary lymph nodes in patients with a suspicious breast
lesion.
A quantitative correlational study was performed at a private hospital in
Johannesburg. A quota non-probability sampling technique was used and
101 patients with suspicious breast lesions and who were referred for an
axillary lymph node dissection and/or sentinel node biopsy were invited to
partake in the study. All patients were scanned using a high-tech
ultrasound machine with a high frequency transducer. A standard
scanning procedure was set up as well as a checklist to ensure all patients
were scanned alike.
The study sample comprised of only female patients, with the majority
being Caucasian and aged between 50-60. The study found that the only
biological factors that influenced the metastatic spread was the size of the
tumour (>2cm) and the location of the tumour (areolar region), the side of
breast as well as the age, gender and ethnicity of the patient has no effect
on the metastatic spread.
The study found that the conventional ultrasound criteria (>2cm in length,
round in shape, loss of fatty hilum and inhomogenous) is accurate in the
detection of late stage metastatic disease. However, it is not accurate in
early stages of axillary lymph node metastatic disease. The study
furthermore confirmed that the size, echogenicity and echotexture were
poor predictors of malignancy.
With the inclusion of an extended ultrasound criteria (focal cortical
thickening ≥3mm and peripheral vascular flow), the research statistics
showed positive results with high sensitivity and specificity. Metastatic
axillary lymph nodes with a focal cortical thickness ≥3mm had a 92%
sensitivity and a p-value of 0.000 whilst, the peripheral vascular pattern...