Accuracy of MRI Versus Ultrasound/Mammography in Detecting Axillary Lymph Node Involvement in Patients with Breast Cancer

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AuthorSaba Ebrahimianen
AuthorAtieh Akbarien
AuthorSakineh Soleimani Varakien
AuthorSaba Amirhosseinien
AuthorMohammad Esmaeil Akbarien
AuthorShabnam Ashoftebargien
OrcidSaba Ebrahimian [0000-0001-7255-4289]en
OrcidSakineh Soleimani Varaki [0000-0003-1839-0388]en
OrcidSaba Amirhosseini [0009-0004-6983-8693]en
OrcidMohammad Esmaeil Akbari [0000-0002-9938-3587]en
OrcidShabnam Ashoftebargi [0009-0009-8311-4006]en
Issued Date2025-12-31en
AbstractBackground: Precise preoperative assessment of axillary lymph nodes is critical in managing breast cancer. While sentinel lymph node biopsy (SLNB) is widely regarded as the standard diagnostic method, its invasiveness and risk of complications limit its utility. Magnetic resonance imaging (MRI) offers a promising noninvasive alternative; however, its clinical value in this context remains inconclusive. This study assessed and compared the diagnostic accuracy of ultrasound and mammography with MRI for evaluating axillary nodal metastasis in breast cancer. Key diagnostic metrics — sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) — were calculated for each imaging modality. Objectives: The objective was to determine whether MRI enhances diagnostic precision in nodal staging prior to surgery and to inform improved imaging strategies for clinical decision-making. Methods: This retrospective analysis examined 150 individuals with a confirmed diagnosis of primary invasive breast cancer. The research team conducted this retrospective observational study between 2016 and 2021 at the Cancer Research Center of Shahid Beheshti University of Medical Sciences. The study enrolled women diagnosed with a first episode of invasive breast cancer confirmed through histopathological analysis. All included patients underwent preoperative imaging, including mammography, ultrasound, and/or MRI. Exclusion criteria were male breast cancer, absence of preoperative axillary imaging, and incomplete clinical data. Participants were stratified into two cohorts based on imaging modality: One was assessed using MRI, and the other with sonography and mammography (SM). Diagnostic performance metrics — including sensitivity, specificity, PPV, and NPV — were computed for both groups and evaluated about definitive postoperative histopathological results. Results: The comparative diagnostic value of MRI versus conventional imaging in axillary staging remains a key concern in breast cancer management. Magnetic resonance imaging demonstrated 72.3% sensitivity and 35.3% specificity in this study, corresponding PPV and NPV values of 58.8% and 50%. The SM group demonstrated similar sensitivity (72.2%) but lower specificity (25%), with PPV of 52% and NPV of 44.4%. These metrics underscore the limited discriminatory capacity of both methods and merit careful contextualization within existing evidence. Conclusions: Magnetic resonance imaging did not demonstrate superior diagnostic performance to SM in evaluating axillary lymph nodes prior to surgery. Considering the similar accuracy, faster imaging process, and lower associated costs, SM appears to be a suitable first-line modality for preoperative axillary assessment.en
DOIhttps://doi.org/10.5812/ijcm-162212en
KeywordBreast Canceren
KeywordAxillary Lymph Nodesen
KeywordMagnetic Resonance Imagingen
KeywordUltrasounden
KeywordMammographyen
PublisherBrieflandsen
TitleAccuracy of MRI Versus Ultrasound/Mammography in Detecting Axillary Lymph Node Involvement in Patients with Breast Canceren
TypeResearch Articleen

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