Comparative Study of Strain Elastography with Histopathological Examination for Axillary Lymph Node Assessment in Breast Cancer Patients

Abstract

Background: Breast cancer is the most prevalent malignancy among women globally, with axillary lymph node status playing a pivotal role in determining prognosis and treatment. Traditional methods for evaluating lymph node involvement, such as axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB), are invasive and associated with significant morbidity, including lymphedema. Materials and Methods: This hospital-based prospective observational study was conducted at Assam Medical College and Hospital from February 2023 to January 2024 and included breast cancer patients with both palpable and non-palpable lymph nodes. The diagnostic performance of strain elastography was compared to histopathological results. Sensitivity, specificity, and accuracy of strain elastography were analyzed. Results: A total of 42 female breast cancer patients were included in the study of which 32 patients had clinically palpable lymph nodes. On performing strain elastography of the lymph nodes, 26 patients (61.9%) showed hard consistency, 5 showed soft consistency and rest of the 11 patients had the indicator of strain elastography mode pointed in the intermediate zone. Comparing with histopathological examination of lymph nodes, strain elastography was found to have 80% sensitivity and a specificity of 64.71%. Conclusion: Strain elastography shows promise as a non-invasive diagnostic tool for assessing axillary lymph node involvement in breast cancer, potentially reducing the need for invasive surgical procedures. This method could enhance patient comfort, reduce healthcare costs, and improve early diagnosis and treatment outcomes.