ObjectiveTo explore the value of ultrasound (US), real-time tissue elastography (RTE) and fine needle aspiration cytology (FNAC) in the diagnosis of axillary lymph node (ALN) status in patients with invasive breast cancer of non-special type (IBC-NST).

MethodsA total of 107 ALNs from 96 female IBC-NST patients were included in the study, each lymph node underwent US, RTE and FNAC examination.The target lymph nodes were scored according to the characteristics of the 2-dimensional acoustic image of the target lymph nodes.According to the elastography color distribution of the lymph node, the different RTE elastic maps were scored.The above two scores were added up.Finally, the FNAC or histopathological results were used as the diagnostic gold standard, the receiver operator characteristic (ROC) curve of the three methods was constructed, and the boundary value of score, the area under the curve (AUC) and the diagnostic efficacy of the three methods were calculated, respectively.

ResultsThe sensitivity and specificity of US, RTE, US combined RTE and FNAC for diagnosing ALN status in IBC-NST patients were 74.6%, 77.3%;76.2%, 86.4%;88.9%, 79.5%, and 88.9%, 100%, respectively.The AUC of US, RTE and the combined method were 0.814, 0.844 and 0.915, respectively.

ConclusionsUS and RTE techniques show better diagnostic value for ALN status in IBC-NST patients, and the combination of the two was more advantageous.FNAC has the highest diagnostic efficacy, but there is still a partial false-negative rate.