{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T15:20:51Z","timestamp":1781191251625,"version":"3.54.1"},"reference-count":25,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Axillary lymph node (ALN) status is one of the most important prognostic factors in breast cancer. Numerous studies have evaluated less invasive methods for accurate staging. To investigate the diagnostic performance of ultrasound (US), mammography, and 18F-fluorodeoxyglucose positron emission tomography\/computed tomography (18F-FDG PET\/CT) in predicting axillary lymph node metastasis in breast cancer patients. Materials and Methods: Axillary involvement detected by US, mammography, and 18F-FDG PET\/CT was analyzed in patients who underwent axillary dissection. Preoperatively, 365, 318, and 85 of 557 patients were evaluated with US, mammography, and PET\/CT, respectively. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of each imaging modality were calculated. Results: The sensitivity, specificity, PPV, NPV, and accuracy of US were 33.3%, 97.5%, 94.4%, 51.0%, and 57.8%, respectively. False-negative US findings were more frequent in T1 (84.6%) and N1 (76.3%) tumors (p &lt; 0.001 for both). For mammography, these values were 12.9%, 97.74%, 88.89%, 44.67%, and 52.9%, while for 18F-FDG PET\/CT they were 72.5%, 100%, 100%, 67.65%, and 82.5%, respectively. Conclusions: Ultrasound remains useful for evaluating axillary lymph node involvement in advanced breast cancer but is insufficient for early-stage disease.<\/jats:p>","DOI":"10.3390\/medicina62020320","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T12:51:56Z","timestamp":1770209516000},"page":"320","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Sensitivity, Specificity, and Accuracy of Ultrasound, Mammography, and 18F-FDG PET\/CT in Diagnosing Breast Cancer Metastasis to Axillary Lymph Nodes: A Single-Center Experience"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4199-6943","authenticated-orcid":false,"given":"Gokmen","family":"Aktas","sequence":"first","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, Gaziantep Medical Point Private Hospital, TR-27310 Gaziantep, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakan","family":"Buyukhatipoglu","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, Gaziantep State Hospital, TR-27470 Gaziantep, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tulay","family":"Kus","sequence":"additional","affiliation":[{"name":"Gaziantep Oncology Hospital, Division of Medical Oncology, Department of Internal Medicine, School of Medicine, Gaziantep University, TR-27310 Gaziantep, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet Emin","family":"Kalender","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, Gaziantep Medical Point Private Hospital, TR-27310 Gaziantep, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7858-5123","authenticated-orcid":false,"given":"Hamit","family":"Y\u0131ld\u0131z","sequence":"additional","affiliation":[{"name":"Gaziantep University Hospital, Department of Internal Medicine, School of Medicine, Gaziantep University, TR-27310 Gaziantep, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talha","family":"Y\u0131ld\u0131z","sequence":"additional","affiliation":[{"name":"Gaziantep University Hospital, Department of Internal Medicine, School of Medicine, Gaziantep University, TR-27310 Gaziantep, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0499-8918","authenticated-orcid":false,"given":"Alper","family":"Sevin\u00e7","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, Gaziantep Medical Point Private Hospital, TR-27310 Gaziantep, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seval","family":"Kul","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, School of Medicine, Gaziantep University, TR-27310 Gaziantep, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celaletdin","family":"Camci","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Istanbul Tema Hospital, TR-34310 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1093\/annonc\/mdi089","article-title":"Avoiding axillary dissection in breast cancer surgery: A randomized trial to assess the role of axillary radiotherapy","volume":"16","author":"Veronesi","year":"2005","journal-title":"Ann. Oncol."},{"key":"ref_2","first-page":"A55","article-title":"Randomized trial comparing axillary clearance versus no axillary clearance in older patients with breast cancer: First results of International Breast Cancer Study Group Trial 10-93","volume":"203","author":"Rudenstam","year":"2006","journal-title":"J. Am. Coll. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1097\/SLA.0b013e31827660a8","article-title":"Axillary dissection versus no axillary dissection in older patients with T1N0 breast cancer: 15-year results of a randomized controlled trial","volume":"256","author":"Martelli","year":"2012","journal-title":"Ann. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1245\/s10434-008-0229-z","article-title":"Sentinel-lymph-node-based management or routine axillary clearance? One-year outcomes of the Sentinel Node versus Axillary Clearance (SNAC) randomized trial","volume":"16","author":"Gill","year":"2009","journal-title":"Ann. Surg. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/j.ejso.2007.05.017","article-title":"Morbidity comparison of sentinel lymph node biopsy versus conventional axillary lymph node dissection for breast cancer patients: Results of the Sentinella-GIVOM Italian randomized clinical trial","volume":"34","author":"Zavagno","year":"2008","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1093\/jnci\/djj158","article-title":"Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: The ALMANAC Trial","volume":"98","author":"Mansel","year":"2006","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1097\/SLA.0b013e3181f08f32","article-title":"Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: The American College of Surgeons Oncology Group Z0011 randomized trial","volume":"252","author":"Giuliano","year":"2010","journal-title":"Ann. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1016\/j.ejso.2015.05.007","article-title":"Axillary lymph node dissection versus sentinel lymph node biopsy alone for early breast cancer with sentinel node metastasis: A meta-analysis","volume":"41","author":"Li","year":"2015","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1002\/jso.21535","article-title":"Morbidity results from the NSABP B-32 trial comparing sentinel lymph node dissection versus axillary dissection","volume":"102","author":"Ashikaga","year":"2010","journal-title":"J. Surg. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1245\/s10434-013-3229-6","article-title":"Value of preoperative ultrasound-guided axillary lymph node biopsy for preventing completion axillary lymph node dissection in breast cancer: A systematic review and meta-analysis","volume":"21","author":"Diepstraten","year":"2014","journal-title":"Ann. Surg. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.jss.2013.03.068","article-title":"Axillary ultrasound in patients with clinically node-negative breast cancer: Which features are predictive of disease?","volume":"184","author":"Elmore","year":"2013","journal-title":"J. Surg. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"W314","DOI":"10.2214\/AJR.12.9032","article-title":"The efficacy of axillary ultrasound in the detection of nodal metastasis in breast cancer","volume":"200","author":"Lee","year":"2013","journal-title":"Am. J. Roentgenol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"696","DOI":"10.2214\/AJR.12.9036","article-title":"Utility of preoperative ultrasound for predicting pN2 or higher stage axillary lymph node involvement in patients with newly diagnosed breast cancer","volume":"200","author":"Abe","year":"2013","journal-title":"Am. J. Roentgenol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1016\/j.breast.2013.09.002","article-title":"Axillary ultrasound for preoperative nodal staging in breast cancer patients: Is it of added value?","volume":"22","author":"Schipper","year":"2013","journal-title":"Breast"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1016\/j.ultrasmedbio.2012.07.011","article-title":"False-negative results of preoperative axillary ultrasound in patients with invasive breast cancer: Correlations with clinicopathologic findings","volume":"38","author":"Choi","year":"2012","journal-title":"Ultrasound Med. Biol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1835","DOI":"10.1016\/j.ultrasmedbio.2015.03.024","article-title":"Sensitivity, specificity and accuracy of ultrasound in diagnosis of breast cancer metastasis to the axillary lymph nodes in Chinese patients","volume":"41","author":"Zhang","year":"2015","journal-title":"Ultrasound Med. Biol."},{"key":"ref_17","first-page":"559","article-title":"False-negative results in axillary lymph nodes by ultrasonography and ultrasonography-guided fine-needle aspiration in patients with invasive ductal carcinoma","volume":"34","author":"Park","year":"2013","journal-title":"Ultraschall Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.crad.2010.11.015","article-title":"Staging primary breast cancer: Are there tumour pathological features that correlate with a false-negative axillary ultrasound?","volume":"66","author":"Johnson","year":"2011","journal-title":"Clin. Radiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2229","DOI":"10.1245\/s10434-014-3617-6","article-title":"A predictive tool to estimate the risk of axillary metastases in breast cancer patients with negative axillary ultrasound","volume":"21","author":"Meretoja","year":"2014","journal-title":"Ann. Surg. Oncol."},{"key":"ref_20","first-page":"177","article-title":"The role of 18F-FDG PET\/CT in the diagnosis of breast cancer and lymph node metastases and micrometastases may be limited","volume":"17","author":"Zhang","year":"2014","journal-title":"Hell. J. Nucl. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1258\/ar.2012.110635","article-title":"Comparison of the diagnostic value of FDG-PET\/CT and axillary ultrasound for the detection of lymph node metastases in breast cancer patients","volume":"53","author":"Riegger","year":"2012","journal-title":"Acta Radiol."},{"key":"ref_22","first-page":"429","article-title":"A comparative study of 18F-FDG PET\/CT and ultrasonography in the diagnosis of breast cancer and axillary lymph node metastasis","volume":"61","author":"He","year":"2015","journal-title":"Q. J. Nucl. Med. Mol. Imaging"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Hadebe, B., Harry, L., Ebrahim, T., Pillay, V., and Vorster, M. (2023). The Role of PET\/CT in Breast Cancer. Diagnostics, 13.","DOI":"10.3390\/diagnostics13040597"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e15734056304849","DOI":"10.2174\/0115734056304849240702071319","article-title":"Comparison of the Performance of [18F]-FDG PET\/CT and [18F]-FDG PET\/MRI for Lymph Node Metastasis in Breast Cancer: A Systematic Review and Meta- Analysis","volume":"20","author":"Han","year":"2024","journal-title":"Curr. Med. Imaging"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/s40336-021-00426-z","article-title":"Breast cancer: Initial workup and staging with FDG PET\/CT","volume":"9","author":"Groheux","year":"2021","journal-title":"Clin. Transl. Imaging"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/2\/320\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T13:11:42Z","timestamp":1770210702000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/2\/320"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,4]]},"references-count":25,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["medicina62020320"],"URL":"https:\/\/doi.org\/10.3390\/medicina62020320","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,4]]}}}