ĐỐI CHIẾU KẾT QUẢ SIÊU ÂM HẠCH NÁCH VỚI KẾT QUẢ GIẢI PHẪU BỆNH SAU MỔ TRONG PHẪU THUẬT UNG THƯ VÚ TẠI BỆNH VIỆN K

Abstract

Background: Breast cancer is considered as a systemic disease, especially in lymph nodes metastases stage, when treatment is multimodality. Axillary ultrasound is a crucial pre-operative workup for evaluation stages and first-choice treatment. In addition, ultrasound also plays an important role in choosing patient for sentinel-lymph nodes biopsy in early breast cancer. Objectives: This study evaluate rates of lymph nodes metastasis in patients with normal axillary lymph nodes ultrasound results by comparing ultrasound results and post-operative pathology results. In contemporary evaluating related factors forecasting lymph nodes metastasis in operable-breast cancer. Methods: Description of cross-sectional series of patients diagnosed as operable breast cancer which lymph nodes are normal or suspected of metastatis in ultrasound. Treatment is mastectomy or breast-conserving surgery with lymph node dissection, at Optimal Care Unit in K hospital from December 2022 to July 2023. Results: 105 breast cancer patients are diagnosed as operable stages, treated with mastectomy or breast-conserving surgery, compared results of clinical axillary ultrasound versus post-operative pathology results. In which there are 3 patients diagnosed as intraductal carcinoma and 102 patients are invasive carcinoma. In 102 cases, rates of T1 and T2 stage are 55.9% and 44.1%, respectively. The average age is 52.25. The majority of tumor histopathology is invasive ductal carcinoma, 88 cases accounted for 86.7%. The average number of lymph nodes dissection is 15.2, at most of 29 and at least of 6. Lymph nodes metastasis represents in 30 patients, accounted for 28.6%. The rate of lymph nodes metastasis in normal clinical axillary lymph nodes ultrasound is 21.7%, appeared as average of 1.4 lymph nodes. That number in suspected ultrasound group are 41.7% and 2.73 lymph nodes. Conclusions: The study shows that ultrasound is a non-invasive and effective method in evaluation of preoperative lymph node staging. The study also recommend perform fine needle aspiration if ultrasound detect positive lymph nodes, before sentinel lymph nodes biopsy procedure. There are differences in rate and number of lymph nodes metastasis between normal and suspected ultrasound results, statistical significance.