Diagnostic value of multiple ultrasound diagnostic techniques for axillary lymph node metastases in breast cancer: A systematic analysis and network meta-analysis

Jun Li; Si-Rui Wang; Qiao-Li Li; Tong Zhu; Pei-Shan Zhu; Ming Chen; Xin-Wu Cui

doi:10.3389/fonc.2022.1043185

Diagnostic value of multiple ultrasound diagnostic techniques for axillary lymph node metastases in breast cancer: A systematic analysis and network meta-analysis

Front Oncol. 2023 Jan 6:12:1043185. doi: 10.3389/fonc.2022.1043185. eCollection 2022.

Authors

Jun Li^{1

2}, Si-Rui Wang^{1

2}, Qiao-Li Li^{1

2}, Tong Zhu³, Pei-Shan Zhu^{1

2}, Ming Chen¹, Xin-Wu Cui⁴

Affiliations

¹ Department of Medical Ultrasound, the First Affiliated Hospital of Medical College, Shihezi University, Xinjiang, China.
² NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases (First Affiliated Hospital, School of Medicine, Shihezi University), Shihezi, Xinjiang, China.
³ School of Medicine, Shihezi University, Shihezi, China.
⁴ Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Abstract

Background: Early diagnosis of axillary lymph node metastasis is very important for the recurrence and prognosis of breast cancer. Currently, Lymph node biopsy is one of the important methods to detect lymph node metastasis in breast cancer, however, its invasiveness might bring complications to patients. Therefore, this study investigated the diagnostic performance of multiple ultrasound diagnostic methods for axillary lymph node metastasis of breast cancer.

Materials and methods: In this study, we searched PubMed, Web of Science, CNKI and Wan Fang databases, conducted Bayesian network meta-analysis (NMA) on the studies that met the inclusion criteria, and evaluated the consistency of five different ultrasound imaging techniques in axillary lymph node metastasis of breast cancer. Funnel graph was used to evaluate whether it had publication bias. The diagnostic performance of each ultrasound imaging method was ranked using SUCRA.

Results: A total of 22 papers were included, US+CEUS showed the highest SUCRA values in terms of sensitivity (SEN) (0.874), specificity (SPE) (0.911), positive predictive value (PPV) (0.972), negative predictive value (NPV) (0.872) and accuracy (ACC) (0.990).

Conclusion: In axillary lymph node metastasis of breast cancer, the US+CEUS combined diagnostic method showed the highest SUCRA value among the five ultrasound diagnostic methods. This study provides a theoretical basis for preoperative noninvasive evaluation of axillary lymph node metastases in breast cancer patients and clinical treatment decisions.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022351977.

Keywords: breast cancer; contrast-enhanced ultrasound; lymph nodes metastasis; network meta-analysis; ultrasound; ultrasound elastography.

Publication types

Systematic Review