{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T23:05:24Z","timestamp":1782947124255,"version":"3.54.5"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,2,9]],"date-time":"2018-02-09T00:00:00Z","timestamp":1518134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine whether imaging and clinicopathologic features could predict false\u2010positive axillary ultrasound (US) results in the selection of patients with breast cancer who had a heavy axillary tumor burden (\u22653 tumor\u2010involved nodes).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Among 788 patients with histologically confirmed invasive breast cancer at Ruijin Hospital from October 2014 to September 2015, 162 patients (cT1\u2010T2, cN0) with 167 axillae had suspicious axillary US findings. Ultrasound findings were considered suspicious for metastasis if cortical thickening of greater than 3\u2009mm or effacement of the fatty hilum was present. The false\u2010positive rate of suspicious axillary US results for identifying 3 or more positive lymph nodes in the final pathologic examination was calculated. Univariate and multivariate analyses were used to evaluate imaging and clinicopathologic factors related to the false\u2010positive results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Axillary US showed a false\u2010positive rate of 60.5% (101 of 167) in the patients with breast cancer and a heavy nodal burden. By logistic regression analyses, we found false\u2010positive axillary US results more frequently in patients who had a T1 stage tumor (<jats:italic>P<\/jats:italic>\u2009=\u2009.005), an estrogen receptor\/progesterone receptor\u2013negative tumor (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), solitary suspicious nodes identified on axillary US (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), and a cortical thickness of the most suspicious lymph node of 3.5\u2009mm or less (<jats:italic>P<\/jats:italic>\u2009=\u2009.015).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Imaging and clinicopathologic features can be used to identify axillae with less than 3 metastatic nodes in patients with early\u2010stage breast cancer who have positive axillary US results. In the post\u2013American College of Surgeons Oncology Group Z0011 trial era, conducting a secondary evaluation either clinically or by axillary imaging before the use of a US\u2010guided biopsy of suspicious nodes can potentially avoid the additional morbidity of axillary lymph node dissection and reduce the preoperative workload.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.14545","type":"journal-article","created":{"date-parts":[[2018,2,9]],"date-time":"2018-02-09T13:02:44Z","timestamp":1518181364000},"page":"1357-1365","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Preoperative Axillary Ultrasound in the Selection of Patients With a Heavy Axillary Tumor Burden in Early\u2010Stage Breast Cancer: What Leads to False\u2010Positive 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