Scientific Presentation Award: The combination of axillary ultrasound and ultrasound-guided biopsy is an accurate predictor of axillary stage in clinically node-negative breast cancer patients

Dana M. Holwitt, Mary Ellen Swatske, William E. Gillanders, Barbara S. Monsees, Feng Gao, Rebecca L. Aft, Timothy J. Eberlein, Julie A. Margenthaler

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

Background: The study aim was to determine the accuracy of axillary ultrasound (AUS) and fine-needle aspiration biopsy (FNAB)/needle core biopsy in axillary breast cancer staging. Methods: We reviewed 256 patients with clinically node-negative breast cancer who underwent AUS ± FNAB/needle core biopsy. AUS-guided FNAB/needle core biopsy was compared with histopathology to determine sensitivity, specificity, negative predictive value, and positive predictive value. Results: AUS-guided FNAB/needle core biopsy and final pathology were positive in 72 of 256 patients (28%). In 125 of 256 cases (49%), the AUS and final pathology were negative. Two of 110 patients had a false-positive FNAB (1.8%); both received neoadjuvant chemotherapy. Nine patients (8%) had a false-negative FNAB/needle core biopsy; the median size of lymph node metastasis was 3 mm. The sensitivity and specificity of AUS-guided FNAB/needle core biopsy was 71% and 99%, respectively, with a negative predictive value of 84% and a positive predictive value of 97%. Conclusions: AUS-guided FNAB/needle core biopsy is accurate in predicting the status of the axilla in 70% of clinically node-negative breast cancer patients. This technique is minimally invasive with a low complication rate and can obviate the need for staged lymph node procedures.

Original languageEnglish
Pages (from-to)477-482
Number of pages6
JournalAmerican journal of surgery
Volume196
Issue number4
DOIs
StatePublished - Oct 2008

Keywords

  • Axillary ultrasound
  • Breast cancer
  • Fine-needle aspiration biopsy

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