Introduction: There are many imaging methods with the help of which lymph nodes can be seen. Among all these techniques ultrasound has remain the most useful which help not only to detect local disease in the breast but also evaluate draining regional lymph nodes.It is usually difficult to differentiate the benign reactive changes and early signs of metastatic disease in breast. This may result in “suspicious“ lymph node.Ultrasonographical examination of suspicious or metastatic – appearing axillary lymph nodes if followed by fine needle aspiration gives a more accurate diagnosis of disease compared to sonography alone. Aim: To assess the role of preoperative ultrasound guided fine-needle aspiration cytology to diagnose axillary metastases in early breast cancer. Materials ans Methods: A prospective analytical study was conducted at Indraprastha Apollo Hospital, New Delhi. 60 patients admitted in Surgical Oncology wards from May 2013 till May 2015 with diagnosis of early Breast carcinoma were enrolled in the study. Preoperative ultrasonography with subsequent FNAC in patients with
suspicious axillary lymph nodes was performed. All patients underwent surgery and followed by a level 2 axillary dissection. The axillary lymph node status was first determined by Ultrasound-guided FNAC in the preliminary staging process. This was compared with the final status of histopathological examination of the axillary lymph nodes that were removed in the axillary dissection. Results: Suspicious lymph nodes were found in 50% of women who were enrolled the study. Of these 30 suspicious nodes that underwent FNAC, 60% of women were having metastatic disease. The sensitivity of US-FNAC was 75% and specificity was 100% with PPV and NPV 100% and 85.7% respectively. Conclusion: Ultrasound guided FNAC has a decent sensitivity and a near perfect specificity to diagnose metastatic nodes in early breast cancer patients.

Keywords: Ultrasonography guided FNAC; Breast CA; Regional lymph nodes.