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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?
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  • İsmail Ozler,
  • Hale Aydin,
  • Onur Can Guler,
  • Işıl Esen Bostancı,
  • Bahar Şahin Güner,
  • Niyazi Karaman,
  • Lütfi Doğan,
  • Cihangir Özaslan
İsmail Ozler
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Hale Aydin
Radiology Clinics of University of Health Sciences, Ankara Oncology Education and Research Hospital, Ankara, Turkey
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Onur Can Guler
General Surgery Clinics of University of Health Sciences, Ankara Oncology Education and Research Hospital, Ankara, Turkey
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Işıl Esen Bostancı
Radiology Clinics of University of Health Sciences, Ankara Oncology Education and Research Hospital, Ankara, Turkey
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Bahar Şahin Güner
Radiology Clinics of University of Health Sciences, Ankara Oncology Education and Research Hospital, Ankara, Turkey
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Niyazi Karaman
General Surgery Clinics of University of Health Sciences, Ankara Oncology Education and Research Hospital, Ankara, Turkey
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Lütfi Doğan
Dr Abdurrahman Yurtaslan Onkoloji Eğitim ve Araştırma Hastanesi
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Cihangir Özaslan
General Surgery Clinics of University of Health Sciences, Ankara Oncology Education and Research Hospital, Ankara, Turkey
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Abstract

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.

Peer review status:ACCEPTED

16 Dec 2020Submitted to International Journal of Clinical Practice
17 Dec 2020Submission Checks Completed
17 Dec 2020Assigned to Editor
07 Jan 2021Reviewer(s) Assigned
24 Jan 2021Review(s) Completed, Editorial Evaluation Pending
17 Apr 20211st Revision Received
22 Apr 2021Submission Checks Completed
22 Apr 2021Assigned to Editor
01 May 2021Review(s) Completed, Editorial Evaluation Pending
03 May 2021Editorial Decision: Accept