Have an account? Please log in.
Text size: Small font Default font Larger font
.
Radiology Daily
Radiology Daily PracticalReviews.com Radiology Daily

Fine-Needle Aspiration Biopsy of Axillary Nodes Useful in Staging Breast Cancer

February 19, 2008
Written by: , Filed in: Breast Imaging
  • Comments
.

The objective of a recent study was to determine the sensitivity and specificity of ultrasound-guided fine-needle aspiration biopsy (US-guided FNAB) of axillary lymph nodes in patients with newly diagnosed breast cancers.

The study has concluded that ultrasound-guided FNAB of axillary lymph nodes has a potential role in the staging of breast cancers.

Design
Retrospective review of 75 US-guided FNABs of axillary lymph nodes.

Methodology
For each newly diagnosed breast cancer, one axillary lymph node, that was either morphologically suspicious or indeterminate or was the largest among benign-appearing lymph nodes, was biopsied. Surgical records, pathology results, and sonographic characteristics were reviewed to determine the sensitivity and specificity of US-guided FNAB technique of axillary lymph nodes.

-----

Related CME

Women's Imaging
University of California San Francisco, Department of Radiology

  The overall goal of this program is to provide current information on the relevant use of imaging and interventional techniques in women with breast and gynecologic pathology. Core concepts and future directions are addressed, including cancer screening, breast intervention, and current status of breast and gynecologic MRI. Up to 20.75 AMA PRA Category 1 Credit(s)™ are available.
Read more or order: Women's Imaging

Imaging Review: Body, Bone & Breast
University of California, San Francisco, Department of Radiology
  This program is designed for the radiologist in clinical practice, and is intended to provide an overview and update on clinically relevant topics in diagnostic imaging, as well as an up-to-date assessment of the clinical uses of modern imaging modalities such as CT, MR and ultrasound. 20 AMA PRA Category 1 Credit(s)™ are available.
  Read more or order: Imaging Review: Body, Bone & Breast

Results of the Study
At surgery, 68% of axillae in the study showed metastatic disease. The average size of index cancers was 3 cm, and the average size of metastatic axillary lymph nodes was 1.83 cm.

There was positive correlation between the size of the cancer and the positivity of US-guided FNAB results. The overall sensitivity was 71%-75%, and the specificity was 100%.

However, the sensitivity improved with an increase in tumor size and more advanced stage of the cancer. The false-positive rate was 13%, and the false-negative rate was 24%.

Conclusions
US-guided FNAB of axillary lymph nodes in patients with newly diagnosed breast cancers has 100% specificity and a sensitivity that improves as the size of the index tumor increases.

Reviewer’s Comments
Axillary nodal status and tumor size are the two most important prognostic factors for breast cancer outcomes. Recently, sentinel node biopsy has been proven to be accurate and safe in evaluating nodal status without traditional axillary nodal dissection, which is associated with significant morbidity and mortality in many patients.

The results of this study suggest that nonsurgical US-guided FNAB may be able to replace surgical sentinel nodal biopsy in selected patients.

Author: Bokran Won, MD

Reference:
Axillary Lymph Nodes: US-Guided Fine-Needle Aspiration for Initial Staging of Breast Cancer–Correlation With Primary Tumor Size.
Koelliker S, Chung MA, et al: Radiology; 2008; 246 (January): 81-89

-----

Related CME

Women's Imaging
University of California San Francisco, Department of Radiology

  The overall goal of this program is to provide current information on the relevant use of imaging and interventional techniques in women with breast and gynecologic pathology. Core concepts and future directions are addressed, including cancer screening, breast intervention, and current status of breast and gynecologic MRI. Up to 20.75 AMA PRA Category 1 Credit(s)™ are available.
Read more or order: Women's Imaging

Imaging Review: Body, Bone & Breast
University of California, San Francisco, Department of Radiology
  This program is designed for the radiologist in clinical practice, and is intended to provide an overview and update on clinically relevant topics in diagnostic imaging, as well as an up-to-date assessment of the clinical uses of modern imaging modalities such as CT, MR and ultrasound. 20 AMA PRA Category 1 Credit(s)™ are available.
  Read more or order: Imaging Review: Body, Bone & Breast
.
  • Comments
.

Would you like to keep current with radiological news and information?

Post Your Comments and Responses

Comments are closed.