Analysis Of The Factors Influence B Ultrasound In Breast Cancer To Assess The False Negative Rate And Negative Predictive Value Of Axillary Lymph Node Metastasis

BackgroundAxillary lymph node metastasis in breast cancer predicts its treatment and prognosis. So the diagnose before the operation seems to be important. With the advantages of non-invasive, convenient and practical, the B ultrasound plays an important role in the preoperative assessment of breast cancer. However, the B ultrasound has its limitation, which are a high false negative rate and low negative predictive value. So this article aims to explore the influencing factors of its false negative rate and negative predictive value.MethodsThe data contains 308 patients from January 2013 to December 2014, who are diagnosed as breast cancer and received an operation in the second Affiliated Hospital of Zhejiang University School of Medicine. Dividing the patient into two groups respectively according to the basic information of the patients, immunohistochemistry marks and B ultrasound description of the primary lesion. With postoperative pathology as the gold standard, analyzing the false negative rate and negative predictive value in the groups by chi-square test. And then analyzing the factors by a logistic regression to identify the independent influencing factors. At the same time, we also analysis the continuous variable such as age, BMI, Ki-67 by the t test.ResultsHer-2 (p=0.006), ER (p=0.049) are the influencing factors of the false negative rate, Her-2 positive or ER-negative will decreases the false negative rate respectively. The logistic regression shows that only Her-2 is the independent influencing factors. Tumor size (p=0.000), Ki-67 (p=0.038) are the influencing factors of the negative predictive value, decreasing of tumor size or Ki-67 increases its negative predictive value respectively. The logistic regression shows that only tumor size is the independent influencing factors.ConclusionsHer-2-positive decreases the false-negative rate of axillary lymph node metastasis predicted by B ultrasound. Tumor size (T≤2cm) increases its negative predictive value. Therefore, B ultrasound combined with breast biopsy and tumor size may play an important role in the prediction of axillary lymph node metastasis.