{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T12:17:30Z","timestamp":1774527450191,"version":"3.50.1"},"reference-count":37,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T00:00:00Z","timestamp":1668729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Natural Science Foundation","award":["81630048"],"award-info":[{"award-number":["81630048"]}]},{"name":"National Natural Science Foundation","award":["81701705"],"award-info":[{"award-number":["81701705"]}]},{"name":"National Natural Science Foundation","award":["201940189"],"award-info":[{"award-number":["201940189"]}]},{"name":"Project of Shanghai Municipal Health Commission","award":["81630048"],"award-info":[{"award-number":["81630048"]}]},{"name":"Project of Shanghai Municipal Health Commission","award":["81701705"],"award-info":[{"award-number":["81701705"]}]},{"name":"Project of Shanghai Municipal Health Commission","award":["201940189"],"award-info":[{"award-number":["201940189"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Whether the morphological changes in axillary lymph node (ALN) have occurred prior to metastasis remains unclear in breast cancer (BC) patients. The aim of this study is to investigate the influence of BC for the morphology of non-metastasis ALN (N\u2212) and, further, to improve the performance of ultrasound (US) examination for metastasis ALN (N+). Materials and Methods: In this retrospective study, 653 patients with breast mass were enrolled and divided into normal group of 202 patients with benign breast tumor, N\u2212 group of 233 BC patients with negative ALN and N+ group of 218 BC patients with positive ALN. US features of ALN were evaluated and analyzed according to long (L) and short (S) diameter, the (L\/S) axis ratio, cortical thickness, lymph node edge, replaced hilum and color Doppler flow imaging (CDFI). Results: ALN US features of short diameter, replaced hilum, cortical thickness and CDFI have significant statistical differences in N\u2212 group comparing with normal group and N+ group, respectively (p &lt; 0.05). Conclusions: Therefore, BC can affect ALN and lead to US morphological changes whether lymph node metastasis is present, which reduces the sensitivity of axillary US. The combination of US and other examination methods should be applied to improve the diagnostic performance of N+.<\/jats:p>","DOI":"10.3390\/medicina58111674","type":"journal-article","created":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T03:07:23Z","timestamp":1669000043000},"page":"1674","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Assessing Whether Morphological Changes in Axillary Lymph Node Have Already Occurred Prior to Metastasis in Breast Cancer Patients by Ultrasound"],"prefix":"10.3390","volume":"58","author":[{"given":"Qiang","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Ultrasound Medicine, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai 201700, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiwu","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Jinshan Branch of Shanghai Sixth People\u2019s Hospital Affiliated to Shanghai Jiaotong University, Shanghai 201599, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lixin","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound in Medicine, Renji Hospital Affiliated to Shanghai Jiaotong University, Shanghai 201599, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziyao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongmo","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1111\/tbj.12122","article-title":"The prognostic significance of nodal ratio on breast cancer recurrence and its potential for incorporation in a new prognostic index","volume":"19","author":"Martin","year":"2013","journal-title":"Breast J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1097\/COC.0000000000000450","article-title":"Prognostic significance of nodal location and ratio in stage iiic endometrial carcinoma among a multi-institutional academic collaboration","volume":"41","author":"Mayadev","year":"2018","journal-title":"Am. 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