Chantal Reyna1, Marie C Lee2, Anne Frelick3, Nazanin Khakpour1, Christine Laronga1, John V Kiluk1. 1. Comprehensive Breast Program, Division of Women's Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA. 2. Comprehensive Breast Program, Division of Women's Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA. Electronic address: M.Catherine.Lee@moffitt.org. 3. University of South Florida Morsani College of Medicine, Tampa, FL, USA.
Abstract
BACKGROUND: Preoperative axillary ultrasound (AUS) and fine-needle aspiration (FNA) are sensitive and specific for breast cancer nodal metastases. We hypothesize that false-negative result predicts minimal axillary disease (≤2 +nodes). METHODS: A retrospective review of breast cancer patients receiving AUS identified T1/T2 tumors and positive sentinel node with axillary dissection. Chi-square analysis was performed using Fisher's exact test. RESULTS: Of 903 AUS cases, 384 had T1/T2 tumors. False-negative rate of AUS ± FNA was 48% and 45%, respectively. Of 384 cases, 73 were sentinel node positive and had axillary dissection; 55 (75.3%) were invasive ductal carcinoma (IDC). Negative predictive value for greater than or equal to 2 nodes was 71% in IDC versus 44% for in non-IDC patients. Sixteen (29.0%) IDC patients had greater than or equal to 3 positive nodes versus 10 (55.5%) non-IDC (P = .05) patients. CONCLUSION: The high negative predictive value for AUS with FNA for IDC suggests that the AUS plus FNA interpretation may be better limited to the ipsilateral nodes of IDC.
BACKGROUND: Preoperative axillary ultrasound (AUS) and fine-needle aspiration (FNA) are sensitive and specific for breast cancer nodal metastases. We hypothesize that false-negative result predicts minimal axillary disease (≤2 +nodes). METHODS: A retrospective review of breast cancerpatients receiving AUS identified T1/T2 tumors and positive sentinel node with axillary dissection. Chi-square analysis was performed using Fisher's exact test. RESULTS: Of 903 AUS cases, 384 had T1/T2 tumors. False-negative rate of AUS ± FNA was 48% and 45%, respectively. Of 384 cases, 73 were sentinel node positive and had axillary dissection; 55 (75.3%) were invasive ductal carcinoma (IDC). Negative predictive value for greater than or equal to 2 nodes was 71% in IDC versus 44% for in non-IDC patients. Sixteen (29.0%) IDC patients had greater than or equal to 3 positive nodes versus 10 (55.5%) non-IDC (P = .05) patients. CONCLUSION: The high negative predictive value for AUS with FNA for IDC suggests that the AUS plus FNA interpretation may be better limited to the ipsilateral nodes of IDC.