To analyze the clinical characteristics and diagnostic value of ultrasound in women with breast cancer aged 70 years and above.

A total of 288 patients (with 298 breast lesions) aged 70 years and above who were treated at the Breast Surgery Department of Peking Union Medical College Hospital from June 2015 to December 2019 with final histopathological results were enrolled in this study, and their clinicopathological and ultrasonographic data were retrospectively analyzed. The fourfold table was used to calculate the total and separate diagnostic efficacy of ultrasonography in patients with different complaints, as well as axillary lymph node metastasis.

In the 288 patients, the complains for which medical advice was sought included self-palpable mass (189, 65.63%), nipple discharge (23, 7.99%), and lesions found by physical or imaging examination (76, 26.39%). The 298 breast lesions included 272 (91.28%) malignant and 26 (9.03%) benign lesions. A total of 263 breast cancer patients received surgery including local tumor resection (60.84%, 160 cases), modified radical mastectomy (27.00%, 71 cases), local tumor resection with axillary dissection or sentinel lymphadenectomy (11.79%, 31 cases), and total mastectomy (0.38%, 1 case). According to the TNM staging system, there were 127 (53.59%) cases of T1 and 79 (33.33%) cases of T2. The sensitivity, specificity, and diagnostic accuracy of ultrasound-based diagnosis were 95.59%, 50.00%, and 91.61%, respectively. The diagnostic accuracy of ultrasonography for the self-palpable mass (including self-touch and physical examination screening findings) was higher than that of nipple discharge (94.53% vs 58.33%). The sensitivity, specificity, and accuracy of ultrasound for diagnosing axillary lymph node metastasis were 93.33%, 73.68%, and 82.35%, respectively.

Most of elderly women with breast cancer visit hospital with clinical symptoms and this may lead to the advanced stage of tumor and delay of care. Ultrasound has an excellent diagnostic accuracy in elderly women with palpable breast mass; however, its accuracy in patients with nipple discharge needs further improvement. Preoperative ultrasound evaluation of axillary lymph nodes has great value in planning treatment strategy.