Axillary staging of breast cancer

The number of axillary lymph nodes containing cancer cells gives good information for assessing prognosis and planning adjuvant treatment.

Clinical examination is not very accurate and may not identify involved nodes pre-operatively.

Ultrasound can sometimes find abnormal nodes that can be biopsied with ultrasound-guidance. If we can confirm that one or more nodes are malignant then the patient can avoid sentinel node biopsy as we know that they will requre a level 2 axillary node dissection.This can save time and money.

Pre-operative ultrasound of the axilla should be considered in all patients with invasive cancer.