Abstract: Objective To investigate the diagnostic value of ultrasonic elastography combined with serum cytokeratin 19 (CK19) and carcinoembryonic antigen (CEA) levels in axillary lymph node metastasis (ALNM) of breast cancer. 
Methods The clinical data of 74 female patients with breast cancer were analyzed retrospectively. According to the postoperative pathological examination results of whether there was ALNM, the patients were divided into metastasis group (n=32) and non-metastasis group (n=42). The score of ultrasonic elastography was compared between the two groups. The value of ultrasound elastography in the diagnosis of ALNM of breast cancer was analyzed. The levels of CK19 and CEA were compared between the two groups. The diagnostic value of CK19 and CEA in ALNM of breast cancer was analyzed. Taking pathological diagnosis as the gold standard, the value of ultrasound elastography combined with CK19 and CEA in the diagnosis of ALNM of breast cancer was analyzed. 
Results The proportion of ultrasound elastography scores 1 and 2 in the metastasis group was significantly lower than that in the non-metastasis group, and the proportion of scores 3 and 4 was significantly higher than that in the non-metastasis group (P＜0.05). The sensitivity, specificity and accuracy of ultrasound elastography in the diagnosis of ALNM of breast cancer were 0.781, 0.952 and 0.878, respectively. The levels of CK19 and CEA in metastasis group were significantly higher than those in non-metastasis group (P＜0.05). The area under the curve of CK19 and CEA in the diagnosis of ALNM of breast cancer was 0.922 and 0.916 respectively, the sensitivity was 0.875 and 0.844 respectively, and the specificity was 0.857 and 0.929 respectively (P＜0.05). The sensitivity, specificity and accuracy of ultrasound elastography combined with CK19 and CEA in the diagnosis of ALNM of breast cancer were 0.938, 0.905 and 0.919, respectively. 
Conclusion The value of ultrasound elastography combined with CK19 and CEA in the diagnosis of ALNM of breast cancer is higher than that of single diagnosis, which warrants attentionin clinical practice. 

Key words: breast neoplasms, elastography techniques, cytokeratin 19, carcinoembryonic antigen