Diagnostic Accuracy and Impact on Management of Ultrasonography-Guided Fine-Needle Aspiration to Detect Axillary Metastasis in Breast Cancer Patients: A Prospective Study

María Jesús Diaz-Ruiz, Anna Arnau, Jesus Montesinos, Ana Miguel, Pere Culell, Lluis Solernou, Lidia Tortajada, Carmen Vergara, Carlos Yanguas, Rafael Salvador-Tarrasón

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    5 Citations (Scopus)

    Abstract

    © 2015 S. Karger GmbH, Freiburg. Copyright: All rights reserved. Background: The axillary nodal status is essential to determine the stage of disease at diagnosis. Our aim was to prospectively assess the diagnostic accuracy of ultrasonography-guided fine-needle aspiration (US-FNA) for the detection of metastasis in axillary lymph nodes in patients with breast cancer (BC) and its impact on the therapeutic decision. Materials and Methods: Ultrasonography (US) was performed in 407 axillae of 396 patients who subsequently underwent surgery. US-FNA was conducted when lymph nodes were detected by US. Axillary dissection (AD) was performed when US-FNA was positive for metastasis. Patients with negative US-FNA and breast tumors of 30 mm in size were candidates for selective sentinel lymph node biopsy (SLNB). The anatomopathological results of AD or SLNB were used as reference tests. Results: Lymph nodes were detected by US in 207 (50.8%) axillae. Of these, US-FNA was performed on 180 (86.9%). 94 axillae (52.2%) were positive for carcinoma and 79 women received AD. US-FNA had 77.5% sensitivity, 100% specificity, 100% positive predictive value, 69.3% negative predictive value, and 85.1% diagnostic accuracy. US-FNA avoided SLNB in 18.1% of patients who underwent AD. Conclusions: Axillary US-FNA is an accurate technique in the staging of patients with BC. It allows reducing the number of SLNB and, when positive, offers a fast and useful tool.
    Original languageEnglish
    Pages (from-to)34-39
    JournalBreast Care
    Volume11
    Issue number1
    DOIs
    Publication statusPublished - 1 Feb 2016

    Keywords

    • Fine-needle aspiration biopsy
    • Lymph node status
    • Staging
    • Treatment strategies
    • Ultrasound

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