{"doi":"10.4048/jbc.2025.0111","title":"Prognostic Role of Preoperative Axillary Ultrasound for Lymph Node Metastasis and Recurrence in Early Stage Breast Cancers","abstract":"<h4>Purpose</h4>Evaluating the role of preoperative axillary ultrasound (US) in early-stage, clinically node-negative breast cancer, focusing on its ability to predict nodal metastasis and long-term recurrence.<h4>Methods</h4>This retrospective study included patients with T1-T2 clinically node-negative breast cancer who underwent preoperative axillary US and surgery between January and December 2009. Based on US findings, patients were classified as US-positive (presence of suspicious nodes, such as cortical thickening or absent fatty hilum) or US-negative. Clinicopathological features and recurrence outcomes were analyzed using the χ² test, Cox proportional hazards regression, and Kaplan-Meier survival analysis.<h4>Results</h4>Among 878 women (mean age, 49 ± 9 years), 234 were US-positive and 644 were US-negative; 283 patients were pathologic node-positive (pN ≥ 1) and 595 were node-negative (pN0). Preoperative axillary US demonstrated a sensitivity of 42.4% (95% confidence interval [CI], 36.8-48.2); specificity, 80.8% (95% CI, 77.5-83.8); positive predictive value, 51.3% (95% CI, 44.9-57.6); and negative predictive value, 74.7% (95% CI, 71.2-77.9). The US-positive group had a higher rate of axillary lymph node dissection (62.8% vs. 32.8%), greater mean number of metastatic nodes (2.6 vs. 0.5), and higher proportion of macrometastasis (94.2% vs. 71.8%) compared with the US-negative group (all <i>p</i> < 0.001). The 10-year recurrence-free survival was lowest in the pN-positive/US-positive group (90.3%; 95% CI, 82.7-94.7), intermediate in the pN-positive/US-negative group (92.4%; 95% CI, 86.7-95.7), and highest in the pN-negative group (97.4%; 95% CI, 95.4-98.5) (log-rank <i>p</i> < 0.001).<h4>Conclusion</h4>Preoperative axillary US might help assess lymph node metastasis in clinically node-negative patients. Moreover, US positivity was associated with an increased risk of long-term recurrence.","journal":"Journal of Breast Cancer","year":2025,"id":5395,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.2319,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":53325,"name":"Eun Young Ko","orcid":"0000-0001-6679-9650","position":1,"is_corresponding":false},{"id":53326,"name":"Boo-Kyung Han","orcid":"0000-0003-1896-0571","position":2,"is_corresponding":false},{"id":53327,"name":"Eun Sook Ko","orcid":"0000-0002-0399-7956","position":3,"is_corresponding":false},{"id":53328,"name":"Ji Soo Choi","orcid":"0000-0003-1361-5269","position":4,"is_corresponding":false},{"id":53329,"name":"Sang Hee Kim","orcid":"0009-0005-1107-7200","position":5,"is_corresponding":false},{"id":53324,"name":"Han Song Mun","orcid":"0000-0003-4718-1788","position":0,"is_corresponding":true}],"reference_count":41,"raw_metadata":null,"created_at":"2026-03-01T18:20:47.508186Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}