Literature DB >> 22717665

Ultrasound and fine needle aspiration cytology of axillary lymph nodes in breast cancer. To do or not to do?

M W H Leenders1, M Broeders, C Croese, M C Richir, H L S Go, B L A M Langenhorst, S Meijer, W H Schreurs.   

Abstract

AIM: The purpose of our study was to evaluate the accuracy of axillary ultrasound and ultrasound-guided fine needle aspiration cytology (FNAC) in the preoperative diagnosis of axillary metastases.
METHODS: Between 2004 and 2009, 1132 female patients were evaluated and treated in our clinic for histologically proven breast carcinoma. Preoperative axillary ultrasound with subsequent FNAC in case of suspicious lymph nodes was performed in 1150 axillae (18 bilateral breast carcinomas). We analyzed the results of axillary ultrasound and FNAC retrospectively. Pathological node status was used as the reference standard (based on axillary dissection or sentinel node biopsy).
RESULTS: Axillary ultrasound showed suspicious lymph nodes in 327 axillae (28.4%). FNAC showed axillary metastases in 107 of these 327 axillae. Final histological analysis confirmed 106 metastases (one false positive). Histological analysis showed metastatic disease in 429 of 1150 axillae (37.3%). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of axillary ultrasound alone were 43.8% (188/429), 80.7% (582/721), 57.5% (188/327) and 70.7% (582/823), respectively. When combining axillary ultrasound with FNAC of suspicious lymph nodes, sensitivity was 24.7% (106/429), specificity was 99.9% (720/721), PPV was 99.1% (106/107) and NPV was 69.0% (720/1043).
CONCLUSIONS: 106/429 (24.7%) Node-positive axillae were identified by ultrasound-guided FNAC and spared unnecessary sentinel node biopsy. Unfortunately, the percentage of false negative results of ultrasound-guided FNAC (28.1%, 323/1150) was very high.
Copyright © 2012 Elsevier Ltd. All rights reserved.

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Year:  2012        PMID: 22717665     DOI: 10.1016/j.breast.2012.05.008

Source DB:  PubMed          Journal:  Breast        ISSN: 0960-9776            Impact factor:   4.380


  15 in total

1.  Usefulness of preoperative breast magnetic resonance imaging with a dedicated axillary sequence for the detection of axillary lymph node metastasis in patients with early ductal breast cancer.

Authors:  Hye Shin Ahn; Mijung Jang; Sun Mi Kim; Bo La Yun; Soo Hyun Lee
Journal:  Radiol Med       Date:  2019-08-17       Impact factor: 3.469

2.  Role of Axillary Ultrasound, Fine Needle Aspiration Cytology and Sentinel Lymph Node Biopsy in clinically N0 Breast Cancer.

Authors:  Gaurav Goel; P D Janaki; N V Smitha; Rajanbabu Anupama; P Shanmugha Sundaram; Y S Nataraj; D K Vijaykumar
Journal:  Indian J Surg Oncol       Date:  2016-04-23

3.  The Relevance of Ultrasound Imaging of Suspicious Axillary Lymph Nodes and Fine-needle Aspiration Biopsy in the Post-ACOSOG Z11 Era in Early Breast Cancer.

Authors:  Gopal R Vijayaraghavan; Srinivasan Vedantham; Milliam Kataoka; Carolynn DeBenedectis; Robert M Quinlan
Journal:  Acad Radiol       Date:  2016-12-01       Impact factor: 3.173

Review 4.  Role of Positron Emission Tomography-Computed Tomography in Locally Advanced Breast Cancer.

Authors:  Pankaj Kumar Garg; Suryanarayana V S Deo; Rakesh Kumar
Journal:  Indian J Surg Oncol       Date:  2015-07-02

5.  Local and regional staging of invasive breast cancer with sonography: 25 years of practice at MD Anderson Cancer Center.

Authors:  Bruno D Fornage
Journal:  Oncologist       Date:  2013-12-05

6.  Lymph node fine needle cytology in the staging and follow-up of cutaneous lymphomas.

Authors:  Elena Vigliar; Immacolata Cozzolino; Marco Picardi; Anna Lucia Peluso; Laura Virginia Sosa Fernandez; Antonio Vetrani; Gerardo Botti; Fabrizio Pane; Carmine Selleri; Pio Zeppa
Journal:  BMC Cancer       Date:  2014-01-06       Impact factor: 4.430

7.  Swedish prospective multicenter trial on the accuracy and clinical relevance of sentinel lymph node biopsy before neoadjuvant systemic therapy in breast cancer.

Authors:  Linda Zetterlund; Fuat Celebioglu; Rimma Axelsson; Jana de Boniface; Jan Frisell
Journal:  Breast Cancer Res Treat       Date:  2017-02-17       Impact factor: 4.872

8.  Accuracy of axillary ultrasound in preoperative nodal staging of breast cancer - size of metastases as limiting factor.

Authors:  Angrit Stachs; Katja Göde; Steffi Hartmann; Bernd Stengel; Ulrike Nierling; Max Dieterich; Toralf Reimer; Bernd Gerber
Journal:  Springerplus       Date:  2013-07-29

Review 9.  Staging the axilla in women with breast cancer: the utility of preoperative ultrasound-guided needle biopsy.

Authors:  Nehmat Houssami; Robin M Turner
Journal:  Cancer Biol Med       Date:  2014-06       Impact factor: 4.248

10.  Preoperative axillary lymph node staging by ultrasound-guided cytology using a four-level sonographic score.

Authors:  Caroline De Coninck; Jean-Christophe Noël; Rachel Boutemy; Philippe Simon
Journal:  BMC Med Imaging       Date:  2016-02-04       Impact factor: 1.930

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