J Surg Ultrasound.  2020 Nov;7(2):21-28. 10.46268/jsu.2020.7.2.21.

Efficacy of Ultrasound-Guided Core Needle Biopsy in Detecting Metastatic Axillary Lymph Nodes in Breast Cancer

Affiliations
  • 1Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea

Abstract

Purpose
Axillary lymph node status is an important prognostic factor in breast cancer. Axillary lymph nodes can be evaluated using fine-needle aspiration cytology (FNAC) or core needle biopsy (CNB) before surgery. This study compared the accuracy and false-negative rates between FNAC and CNB in patients with breast cancer who either did or did not receive neoadjuvant chemotherapy (NAC).
Methods
The clinicopathological factors of the patients were analyzed retrospectively, and the sensitivity, specificity, positive and negative predictive values, false-positive and false-negative rates, and accuracy of FNAC (n = 27) and CNB (n = 23) were compared.
Results
Regardless of whether or not NAC was performed, the CNB evaluation of the metastatic axillary lymph nodes had a 100.0% sensitivity, specificity, negative predictive value, and accuracy, except for one case with an inadequate sample. In the FNAC group, the false-negative rate was higher in patients with breast cancer who received NAC before evaluating the lymph nodes (9.1% vs. 7.7%). Moreover, ultrasound imaging was the most sensitive imaging modality that can detect the suspicious axillary lymph node.
Conclusion
CNB was more effective in evaluating the axillary lymph nodes in breast cancer than FNAC and was performed without major complications.

Keyword

Axillary lymph nodes; Biopsy; Breast cancer; Cytology

Figure

  • Fig. 1 Schematic correlation diagram between fine needle aspiration cytology, core needle biopsy, and pathologic results.


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