Axillary fine needle aspiration cytology for pre-operative staging of patients with screen-detected invasive breast carcinoma.
AuthorsHayes, Brian D
Quinn, Cecily M
Kennedy, M M
O'Connell, Anna Marie
AffiliationDepartment of Histopathology, St Vincent's University Hospital, Dublin 4,, Ireland. email@example.com
Early Detection of Cancer
Predictive Value of Tests
Sensitivity and Specificity
MetadataShow full item record
CitationJ Clin Pathol. 2011 Apr;64(4):338-42. Epub 2011 Jan 22.
JournalJournal of clinical pathology
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.
- Ultrasound and fine needle aspiration cytology of axillary lymph nodes in breast cancer. To do or not to do?
- Authors: Leenders MW, Broeders M, Croese C, Richir MC, Go HL, Langenhorst BL, Meijer S, Schreurs WH
- Issue date: 2012 Aug
- Initial axillary staging of breast cancer using ultrasound-guided fine needle aspiration: a liquid-based cytology study.
- Authors: Schiettecatte A, Bourgain C, Breucq C, Buls N, De Wilde V, de Mey J
- Issue date: 2011 Feb
- Axillary ultrasound and Fine-Needle Aspiration Cytology in the preoperative staging of axillary node metastasis in breast cancer patients.
- Authors: Gipponi M, Fregatti P, Garlaschi A, Murelli F, Margarino C, Depaoli F, Baccini P, Gallo M, Friedman D
- Issue date: 2016 Dec
- The clinical utility of combining pre-operative axillary ultrasonography and fine needle aspiration cytology with radionuclide guided sentinel lymph node biopsy in breast cancer patients with palpable axillary lymph nodes.
- Authors: Usmani S, Ahmed N, Al Saleh N, abu Huda F, Amanguno HG, Amir T, al Kandari F
- Issue date: 2015 Dec
- Preoperative ultrasound-guided fine-needle aspiration cytology for axillary staging in breast carcinoma.
- Authors: Popli MB, Sahoo M, Mehrotra N, Choudhury M, Kumar A, Pathania OP, Thomas S
- Issue date: 2006 Apr