Abstract:

Objective To explore conventional ultrasound combined with contrast ⁃ enhanced ultrasound （CEUS）in predicting axillary lymph node metastasis of breast cancer. Methods Conventional ultrasound and CEUS features of breast cancer tumors（n = 119）were retrospectively collected. According to the postoperative pathological results，the patients were divided into the group with and without axillary lymph node metastasis（ALNM）. And the methods of univariate and multivariate Logistic regression analysis were used to screen out the risk factors associated with ALNM in breast cancer. Logistic regression prediction model was established ，and the receiver operating characteristic（ROC）curve was drawn. Results Univariate analysis showed that there were significant differences between the two groups in maximum diameter of breast cancer，alder blood flow grade，edge burr sign， radial convergence of enhanced edge and range change after enhancement（P < 0.05）. Multivariate analysis showed that the maximum diameter of breast cancer > 2 cm，enhancement of perfusion defect and enhancement of the larger rangewere independent risk factors for ALNM（P < 0.05）. The AUC of these three ultrasound features predicting the ALNM were 0.699，0.616 and 0.664 respectively. The prediction model of the above indicators combined with AUC was 0.791，whichwas greater than that of breast cancer > 2 cm，enhancement of perfusion defect and enhance⁃ ment of the larger range alone（P < 0.05）. The prediction model had a better prediction efficacy through the consis⁃ tency test（Kappa value = 0.607）. Conclusion The maximum diameter of breast cancer > 2 cm，enhancement of perfusion defect and enhancement of the larger range were independent risk factors for ALNM in breast cancer，andthe value of combined use of them had a higher predictive value for ALNM. 

Key words:

 , breast cancer, lymph node metastasis, conventional ultrasound, contrast ?enhanced ultrasound ,