Ultrasound-guided core biopsy: an effective method of detecting axillary nodal metastases.

Hdl Handle:
http://hdl.handle.net/10147/207293
Title:
Ultrasound-guided core biopsy: an effective method of detecting axillary nodal metastases.
Authors:
Solon, Jacqueline G; Power, Colm; Al-Azawi, Dhafir; Duke, Deirdre; Hill, Arnold D K
Affiliation:
Department of Surgery, Beaumont Hospital, Dublin, Ireland; Department of Surgery,, Royal College of Surgeons in Ireland, Dublin, Ireland.
Citation:
J Am Coll Surg. 2012 Jan;214(1):12-7. Epub 2011 Nov 12.
Journal:
Journal of the American College of Surgeons
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207293
DOI:
10.1016/j.jamcollsurg.2011.09.024
PubMed ID:
22079880
Abstract:
BACKGROUND: Axillary nodal status is an important prognostic predictor in patients with breast cancer. This study evaluated the sensitivity and specificity of ultrasound-guided core biopsy (Ax US-CB) at detecting axillary nodal metastases in patients with primary breast cancer, thereby determining how often sentinel lymph node biopsy could be avoided in node positive patients. STUDY DESIGN: Records of patients presenting to a breast unit between January 2007 and June 2010 were reviewed retrospectively. Patients who underwent axillary ultrasonography with or without preoperative core biopsy were identified. Sensitivity, specificity, positive predictive value, and negative predictive value for ultrasonography and percutaneous biopsy were evaluated. RESULTS: Records of 718 patients were reviewed, with 445 fulfilling inclusion criteria. Forty-seven percent (n = 210/445) had nodal metastases, with 110 detected by Ax US-CB (sensitivity 52.4%, specificity 100%, positive predictive value 100%, negative predictive value 70.1%). Axillary ultrasonography without biopsy had sensitivity and specificity of 54.3% and 97%, respectively. Lymphovascular invasion was an independent predictor of nodal metastases (sensitivity 60.8%, specificity 80%). Ultrasound-guided core biopsy detected more than half of all nodal metastases, sparing more than one-quarter of all breast cancer patients an unnecessary sentinel lymph node biopsy. CONCLUSIONS: Axillary ultrasonography, when combined with core biopsy, is a valuable component of the management of patients with primary breast cancer. Its ability to definitively identify nodal metastases before surgical intervention can greatly facilitate a patient's preoperative integrated treatment plan. In this regard, we believe our study adds considerably to the increasing data, which indicate the benefit of Ax US-CB in the preoperative detection of nodal metastases.
Language:
eng
ISSN:
1879-1190 (Electronic); 1072-7515 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorSolon, Jacqueline Gen_GB
dc.contributor.authorPower, Colmen_GB
dc.contributor.authorAl-Azawi, Dhafiren_GB
dc.contributor.authorDuke, Deirdreen_GB
dc.contributor.authorHill, Arnold D Ken_GB
dc.date.accessioned2012-02-01T10:04:10Z-
dc.date.available2012-02-01T10:04:10Z-
dc.date.issued2012-02-01T10:04:10Z-
dc.identifier.citationJ Am Coll Surg. 2012 Jan;214(1):12-7. Epub 2011 Nov 12.en_GB
dc.identifier.issn1879-1190 (Electronic)en_GB
dc.identifier.issn1072-7515 (Linking)en_GB
dc.identifier.pmid22079880en_GB
dc.identifier.doi10.1016/j.jamcollsurg.2011.09.024en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207293-
dc.description.abstractBACKGROUND: Axillary nodal status is an important prognostic predictor in patients with breast cancer. This study evaluated the sensitivity and specificity of ultrasound-guided core biopsy (Ax US-CB) at detecting axillary nodal metastases in patients with primary breast cancer, thereby determining how often sentinel lymph node biopsy could be avoided in node positive patients. STUDY DESIGN: Records of patients presenting to a breast unit between January 2007 and June 2010 were reviewed retrospectively. Patients who underwent axillary ultrasonography with or without preoperative core biopsy were identified. Sensitivity, specificity, positive predictive value, and negative predictive value for ultrasonography and percutaneous biopsy were evaluated. RESULTS: Records of 718 patients were reviewed, with 445 fulfilling inclusion criteria. Forty-seven percent (n = 210/445) had nodal metastases, with 110 detected by Ax US-CB (sensitivity 52.4%, specificity 100%, positive predictive value 100%, negative predictive value 70.1%). Axillary ultrasonography without biopsy had sensitivity and specificity of 54.3% and 97%, respectively. Lymphovascular invasion was an independent predictor of nodal metastases (sensitivity 60.8%, specificity 80%). Ultrasound-guided core biopsy detected more than half of all nodal metastases, sparing more than one-quarter of all breast cancer patients an unnecessary sentinel lymph node biopsy. CONCLUSIONS: Axillary ultrasonography, when combined with core biopsy, is a valuable component of the management of patients with primary breast cancer. Its ability to definitively identify nodal metastases before surgical intervention can greatly facilitate a patient's preoperative integrated treatment plan. In this regard, we believe our study adds considerably to the increasing data, which indicate the benefit of Ax US-CB in the preoperative detection of nodal metastases.en_GB
dc.language.isoengen_GB
dc.titleUltrasound-guided core biopsy: an effective method of detecting axillary nodal metastases.en_GB
dc.contributor.departmentDepartment of Surgery, Beaumont Hospital, Dublin, Ireland; Department of Surgery,, Royal College of Surgeons in Ireland, Dublin, Ireland.en_GB
dc.identifier.journalJournal of the American College of Surgeonsen_GB
dc.description.provinceLeinster-

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