Can We Identify or Exclude Extensive Axillary Nodal Involvement in Breast Cancer Patients Preoperatively?

Table 1

Summary of studies on axillary ultrasonography to exclude patients with extensive nodal involvement.

Study	Year	No. of patients	No. (%) of patients with extensive nodal involvement	No. of false negatives	No. of true negatives	NPV (%)	FNR (%)
Studies in which extensive nodal involvement was defined as pN2-3
Abe et al. [9]	2013	559	60 (10.7%)	10	368	97	17
Amonkar et al. [10]	2013	439	44 (10.0%)	10	283	97	23
Jackson et al. [11]	2015	494	48 (9.7%)	14	369	96	29
Kijima et al. [12]	2010	380	67 (17.6%)	10	238	96	15
Liu et al. [13]	2018	3944	664 (16.8%)	64	2236	97	10
Wely van et al. [14]	2013	1448	178 (12.3%)	89	1094	92	50
Zhang et al. [15]	2015	1049	207 (19.7%)	33	619	95	16
Mean						96	18
Studies in which extensive nodal involvement was defined as ≥3 positive nodes
Barco et al. [16]	2016	1533	210 (13.7%)	64	1127	95	30
Hieken et al. [17]	2013	906	76 (8.4%)	23	620	96	30
Kim et al. [18]	2019	311	19 (6.1%)	6	238	98	32
Kramer et al. [19]	2016	2130	248 (11.6%)	91	1491	94	37
Lee et al. [20]	2013	210	38 (18.1%)	12	130	92	32
Lim et al. [21]	2019	1298	180 (13.9%)	62	950	94	34
Moorman et al. [22]	2014	1060	102 (9.6%)	37	842	96	36
Morrow et al. [23]	2018	4695	594 (12.7%)	206	3374	94	35
Mean						95	34

AxUS = axillary ultrasonography; no. of false negatives = number of patients with normal/negative AxUS but histologically extensive nodal involvement; no. of true negatives = number of patients with normal/negative AxUS and histologically no/limited nodal involvement; NPV = negative predictive value; FNR = false-negative rate.