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Ultrasound-Guided Aspiration Biopsy for Detection of Nonpalpable Axillary Node Metastases in Breast Cancer Patients: New Diagnostic Method

Ultrasound-Guided Aspiration Biopsy for Detection of Nonpalpable Axillary Node Metastases in Breast Cancer Patients: New Diagnostic Method,10.1007/s00

Ultrasound-Guided Aspiration Biopsy for Detection of Nonpalpable Axillary Node Metastases in Breast Cancer Patients: New Diagnostic Method   (Citations: 77)
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. This study was designed to evaluate the accuracy of ultrasonography alone and in combination with fine-needle aspiration biopsy (FNAB) for detection of axillary metastases of nonpalpable lymph nodes in breast cancer patients. Ultrasonography was carried out in 150 axillas of 148 patients (mean age 57 years, range 30–80 years); and in 93 axillas lymph nodes were detected. Nodes were described according to their dimension and echo patterns and were compared with histopathologic results. FNAB was carried out in 81 axillas (122 nodes). The sensitivity of ultrasonography was highest (87%) when size (length >5 mm) was used as criterion for malignancy, but the specificity was rather low (56%). When nodes with a malignant pattern (echo-poor or inhomogeneous) were visualized, specificity was 95%. Ultrasound-guided FNAB had a sensitivity of 80% and a specificity of 100% and detected metastases in 63% of node-positive patients. It is concluded that FNAB is an easy, reliable, inexpensive method for identifying patients with positive nodes. In the case of negative findings, other diagnostic procedures to exclude lymph node metastases, such as sentinel node mapping, could be performed.
Journal: World Journal of Surgery - WORLD J SURGERY , vol. 21, no. 3, pp. 270-274, 1997
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    • ...The sensitivity of pre-operative assessment must be high in order to correctly identify patients who require AC, and the specificity high to avoid subjecting patients unnecessarily to radical surgery. Clinical examination has a low specificity (as many benign conditions can cause palpable lymphadenopathy) and low sensitivity, particularly when the axillary disease burden is low (with a false-negative rate of 45% in one study). ...

    Brian D Hayeset al. Axillary fine needle aspiration cytology for pre-operative staging of ...

    • ...Bonnema et al. [11] studied 150 axillas and reported 36% sensitivity and 95% specificity for axillary ultrasound alone, utilizing abnormal echo patterns (echo-poor lymph node, inhomogenous pattern within the lymph node cortex, loss of fatty hilum) as criteria for malignancy...

    Fatema Al Mushawahet al. Residual Nodal Disease in Biopsy Proven N1/N2 Breast Cancer Following ...

    • ...The variable accuracy of such findings requires needle biopsy confirmation of metastases. Results to date show that 21-63% of lymph node metastases can be diagnosed with ultrasound guided needle biopsy. ...

    Peter D Britton. Breast imaging

    • ...Although some studies have reported no false-positives on axillary node FNAC [9, 12, 14] this is more likely a reflection of the small number of cases sampled with FNAC (and shown to have metastases) than an absolute absence of false-positives for the test...

    Stefano Ciattoet al. Accuracy of fine needle aspiration cytology (FNAC) of axillary lymph n...

    • ...Bonnema and coworkers [10] found 56% specificity and 87% sensitivity for lymph nodes > 5 mm; large nodes are more easily identified, but they increase the false-positive rates...
    • ...In patients without palpable nodes, US-guided FNAC allowed avoidance of 8% to 26% SNBs in the total patient population, resulting in an increase of 21% to 63% of immediate axillary dissection in the presence of metastatic axillary nodes [10, 12, 15, 17, 18]...

    Franco Gentaet al. Cost/Accuracy Ratio Analysis in Breast Cancer Patients Undergoing Ultr...

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