Axillary fine needle aspiration cytology for pre-operative staging of patients with screen-detected invasive breast carcinoma.

Hdl Handle:
http://hdl.handle.net/10147/207640
Title:
Axillary fine needle aspiration cytology for pre-operative staging of patients with screen-detected invasive breast carcinoma.
Authors:
Hayes, Brian D; Feeley, Linda; Quinn, Cecily M; Kennedy, M M; O'Doherty, Ann; Flanagan, Fidelma; O'Connell, Anna Marie
Affiliation:
Department of Histopathology, St Vincent's University Hospital, Dublin 4,, Ireland. brian_hayes@ireland.com
Citation:
J Clin Pathol. 2011 Apr;64(4):338-42. Epub 2011 Jan 22.
Journal:
Journal of clinical pathology
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207640
DOI:
10.1136/jcp.2010.084772
PubMed ID:
21258092
Abstract:
INTRODUCTION: Fine needle aspiration cytology (FNAC) of radiologically abnormal axillary lymph nodes in patients with breast cancer can identify patients suitable for primary axillary clearance (AC) rather than sentinel node biopsy, enabling surgical axillary staging by a single operation. This study assessed the accuracy of FNAC in predicting positive axillary lymph nodes. METHODS: 161 patients with screen-detected invasive carcinoma and who had pre-operative FNAC of a radiologically abnormal axillary lymph node were identified from two screening units, The axillary FNAC reports were correlated with sentinel node biopsy and AC reports, and sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated. RESULTS: FNAC had a moderate sensitivity (66.3%) and NPV (71.8%), and a high specificity (98.7%) and PPV (98.3%). Most patients (86%) had a single axillary operation. The sensitivity was highest in grade 3 (81.8%) and ductal type (77.8%) tumours. The sensitivity was lower in tumours of special type (34.8%), grade 1 tumours (50%) and those without lymphovascular invasion (LVI) (55.9%). The NPV was highest in pT1 (86.7%) and in grade 1 (84.5%) tumours, and lowest (44%) in tumours with LVI. The PPV was 100% in grade 1 and 3 tumours, stage pT2 and pT3 tumours and those without LVI, and was high (>96%) in all other groups. In lymph-node-positive patients, the mean number of lymph nodes involved was higher in the case of a positive (6.4) than negative FNAC (4.4). CONCLUSIONS: FNAC of ultrasonically abnormal axillary lymph nodes achieved surgical staging by a single operation in most patients with screen-detected invasive breast carcinoma, with moderate sensitivity and high specificity.
Language:
eng
MeSH:
Axilla; *Biopsy, Fine-Needle; Breast Neoplasms/*pathology/radiography/surgery; Early Detection of Cancer; Female; Humans; Lymph Nodes/*pathology; Lymphatic Metastasis; Mammography; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Predictive Value of Tests; Preoperative Care/methods; Sensitivity and Specificity
ISSN:
1472-4146 (Electronic); 0021-9746 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorHayes, Brian Den_GB
dc.contributor.authorFeeley, Lindaen_GB
dc.contributor.authorQuinn, Cecily Men_GB
dc.contributor.authorKennedy, M Men_GB
dc.contributor.authorO'Doherty, Annen_GB
dc.contributor.authorFlanagan, Fidelmaen_GB
dc.contributor.authorO'Connell, Anna Marieen_GB
dc.date.accessioned2012-02-01T10:33:40Z-
dc.date.available2012-02-01T10:33:40Z-
dc.date.issued2012-02-01T10:33:40Z-
dc.identifier.citationJ Clin Pathol. 2011 Apr;64(4):338-42. Epub 2011 Jan 22.en_GB
dc.identifier.issn1472-4146 (Electronic)en_GB
dc.identifier.issn0021-9746 (Linking)en_GB
dc.identifier.pmid21258092en_GB
dc.identifier.doi10.1136/jcp.2010.084772en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207640-
dc.description.abstractINTRODUCTION: Fine needle aspiration cytology (FNAC) of radiologically abnormal axillary lymph nodes in patients with breast cancer can identify patients suitable for primary axillary clearance (AC) rather than sentinel node biopsy, enabling surgical axillary staging by a single operation. This study assessed the accuracy of FNAC in predicting positive axillary lymph nodes. METHODS: 161 patients with screen-detected invasive carcinoma and who had pre-operative FNAC of a radiologically abnormal axillary lymph node were identified from two screening units, The axillary FNAC reports were correlated with sentinel node biopsy and AC reports, and sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated. RESULTS: FNAC had a moderate sensitivity (66.3%) and NPV (71.8%), and a high specificity (98.7%) and PPV (98.3%). Most patients (86%) had a single axillary operation. The sensitivity was highest in grade 3 (81.8%) and ductal type (77.8%) tumours. The sensitivity was lower in tumours of special type (34.8%), grade 1 tumours (50%) and those without lymphovascular invasion (LVI) (55.9%). The NPV was highest in pT1 (86.7%) and in grade 1 (84.5%) tumours, and lowest (44%) in tumours with LVI. The PPV was 100% in grade 1 and 3 tumours, stage pT2 and pT3 tumours and those without LVI, and was high (>96%) in all other groups. In lymph-node-positive patients, the mean number of lymph nodes involved was higher in the case of a positive (6.4) than negative FNAC (4.4). CONCLUSIONS: FNAC of ultrasonically abnormal axillary lymph nodes achieved surgical staging by a single operation in most patients with screen-detected invasive breast carcinoma, with moderate sensitivity and high specificity.en_GB
dc.language.isoengen_GB
dc.subject.meshAxillaen_GB
dc.subject.mesh*Biopsy, Fine-Needleen_GB
dc.subject.meshBreast Neoplasms/*pathology/radiography/surgeryen_GB
dc.subject.meshEarly Detection of Canceren_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshLymph Nodes/*pathologyen_GB
dc.subject.meshLymphatic Metastasisen_GB
dc.subject.meshMammographyen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshNeoplasm Invasivenessen_GB
dc.subject.meshNeoplasm Stagingen_GB
dc.subject.meshPredictive Value of Testsen_GB
dc.subject.meshPreoperative Care/methodsen_GB
dc.subject.meshSensitivity and Specificityen_GB
dc.titleAxillary fine needle aspiration cytology for pre-operative staging of patients with screen-detected invasive breast carcinoma.en_GB
dc.contributor.departmentDepartment of Histopathology, St Vincent's University Hospital, Dublin 4,, Ireland. brian_hayes@ireland.comen_GB
dc.identifier.journalJournal of clinical pathologyen_GB
dc.description.provinceLeinster-

Related articles on PubMed

All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.