Can Preoperative Axillary Ultrasound and Biopsy of Suspicious Lymph
Nodes Be An Alternative To Sentinel Lymph Node Biopsy in Clinical Node
Negative Early Breast Cancer?
Aim: The aim of this study was to assess the efficacy of pre-operative
axillary ultrasonography (AUS) and pre-operative axillary fine-needle
aspiration biopsy (FNAB) from suspicious lymph nodes in clinically
node-negative breast cancer to compare with radiologically positive and
sentinel lymph node biopsy (SLNB) positive involvement. Method:
Clinically node-negative early-stage breast cancer patients were
included in the study. These patients under went pre-operative AUS
examination, suspicious lymph nodes were evaluated with FNAB. AUS-FNAB
results were compared with those of SLNB or of axillary dissection.
Results: Of 181 patients undergoing AUS, 32 were reported to have
axillary metastasis, 25 suspicious and 124 benign nodes. The suspicious
group underwent FNAB examination and metastasis was found in 9 of them.
The sensitivity of AUS-FNAB was found to be 64.06%, specificity 100%,
positive predictive value 100% and negative predictive value (NPV)
83.5%. False negativity rate (FN) of this method was 16,4%.
Lymphovascular invasion and tumor size were found statistically
significant factors for false negativity. Conclusion:It was concluded
that axillary AUS-FNAB with its high NPV, low FN rate, may be a clinical
alternative to SLNB for early stage breast cancer patients.