Clinical Value of Preoperative Ultrasound Signs in Evaluating Axillary Lymph Node Status in Triple-Negative Breast Cancer

PURPOSE: To explore the clinical value of preoperative ultrasound signs in evaluating axillary lymph node status in triple-negative breast cancer (TNBC). METHODS: A retrospective study was conducted on 162 patients with TNBC who were admitted to our hospital from January 2017 to June 2021. A total of 62 patients with axillary lymph node metastasis and 100 patients with normal axillary lymph nodes were included. Univariate and logistic regression was used to analyze the correlation between clinicopathological parameters, ultrasound features, and axillary lymph node metastasis between these two groups. The receiver operating characteristic (ROC) curve of each index was drawn to predict positive axillary lymph node. RESULTS: The lymph node positive rate was higher in patients with tumor size (2 mm < T ≤ 5 mm) and tumor stage III, and the difference between these two groups was statistically significant (P < 0.05). The patients with cortical thickness ≥ 3, blood flow grades II-III, aspect ratio (L/S) ≥ 2, and RI ≥ 0.7 had higher lymph node positive rate, and the difference between these two groups was statistically significant (P < 0.05). Other index shows no correlation with ancillary lymph node positive rate, or the correlation was not statistically significant (P > 0.05). Further regression analysis indicated that the blood flow grade and L/S of axillary lymph nodes were independent influencing factors of axillary lymph node metastasis in TNBC patients (P < 0.05). Relevant receiver operating characteristic (ROC) curves were constructed, and the AUC of axillary lymph node blood flow grade and L/S for predicting axillary lymph node status was 0.6329 and 0.6498, respectively. The AUC for the joint prediction of the two indicators is 0.6898. CONCLUSION: Ultrasound sign combined with clinicopathological characteristics can predict the axillary lymph nodes metastasis in TNBC, which could guide clinical decision of axillary lymph node surgery.