ORIGINAL RESEARCH article
Front. Oncol.
Sec. Cancer Imaging and Image-directed Interventions
This article is part of the Research TopicAdvances in Oncological Imaging TechniquesView all 19 articles
Ultrasound-Based Comparative Assessment of Ipsilateral vs. Contralateral Axillary Lymph Nodes in Breast Cancer Patients — A Pilot Study
Provisionally accepted
Nicoleta Zenovia1,2
Roxana Pintican1*Bogdan Fetica2*Carmen Lisencu2
Daria Marian1
Andrei Roman1,2
Adrian Trifa2,3Vlad Gâta1,2Maximilian Muntean2Bogdan Pop1,2Catalin Vlad1,2Patriciu Achimaș Cadariu1,2- 1University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
- 2Institutul Oncologic Prof Dr Ion Chiricuta, Cluj-Napoca, Romania
- 3Universitatea de Medicina si Farmacie Victor Babes din Timisoara, Timișoara, Romania
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Background: Accurate axillary lymph node assessment is critical in breast cancer staging. This study aimed to evaluate whether ultrasound (US)-based measurements, particularly cortical thickness and comparison with contralateral lymph nodes, could improve diagnostic accuracy in detecting axillary metastasis. Methods: In this prospective study, 110 breast cancer patients underwent bilateral axillary US. Ipsilateral and contralateral lymph nodes were assessed for shape, size, cortical characteristics, and hilum preservation. Quantitative features were compared between metastatic and non-metastatic nodes. Diagnostic accuracy was evalu-ated using ROC analysis, and various cut-off values were tested. Results: Metastatic nodes showed significantly increased cortical thickness (median 7.5 mm vs. 2.1 mm, p<0.001), larger short axes, and irregular shapes. The cortical thickness of ipsilateral lymph nodes had an AUC of 0.967 with a 3.4 mm cut-off yielding 97.7% sensitivity and 89.1% specificity. Comparing ipsilateral and contralateral cortical thickness revealed a 2.05 mm difference as optimal (AUC 0.926, 86% sensitivity, 89.1% specificity). US-based assessment outperformed traditional imaging in accuracy (92.66% vs. 82.73%). Conclusions: Quantitative US assessment of axillary lymph nodes, especially cortical thickness and bilateral comparisons, enhances diagnostic accuracy in breast cancer. Integrating these measures may reduce unnecessary biopsies and improve staging efficiency.
Keywords: Axilla, Lymph Nodes, Axillary metastasis, Breast Cancer Metastasis, contralateral lymph nodes
Received: 02 Jul 2025; Accepted: 14 Nov 2025.
Copyright: © 2025 Zenovia, Pintican, Fetica, Lisencu, Marian, Roman, Trifa, Gâta, Muntean, Pop, Vlad and Cadariu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Roxana Pintican, roxana.pintican@gmail.com
Bogdan Fetica, feticab@yahoo.com
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