%0 Journal Article
%T Ultrasound Guided Core Biopsy versus Fine Needle Aspiration for Evaluation of Axillary Lymphadenopathy in Patients with Breast Cancer
%A Marie A. Ganott
%A Margarita L. Zuley
%A Gordon S. Abrams
%A Amy H. Lu
%A Amy E. Kelly
%A Jules H. Sumkin
%A Mamatha Chivukula
%A Gloria Carter
%A R. Marshall Austin
%A Andriy I. Bandos
%J ISRN Oncology
%D 2014
%R 10.1155/2014/703160
%X Rationale and Objectives. To compare the sensitivities of ultrasound guided core biopsy and fine needle aspiration (FNA) for detection of axillary lymph node metastases in patients with a current diagnosis of ipsilateral breast cancer. Materials and Methods. From December 2008 to December 2010, 105 patients with breast cancer and abnormal appearing lymph nodes in the ipsilateral axilla consented to undergo FNA of an axillary node immediately followed by core biopsy of the same node, both with ultrasound guidance. Experienced pathologists evaluated the aspirate cytology without knowledge of the core histology. Cytology and core biopsy results were compared to sentinel node excision or axillary dissection pathology. Sensitivities were compared using McNemarĄŻs test. Results. Of 70 patients with axillary node metastases, FNA was positive in 55/70 (78.6%) and core was positive in 61/70 (87.1%) ( ). The FNA and core results were discordant in 14/70 (20%) patients. Ten cases were FNA negative/core positive. Four cases were FNA positive/core negative. Conclusion. Core biopsy detected six (8.6%) more cases of metastatic lymphadenopathy than FNA but the difference in sensitivities was not statistically significant. Core biopsy should be considered if the node is clearly imaged and readily accessible. FNA is a good alternative when a smaller needle is desired due to node location or other patient factors. This trial is registered with NCT01920139. 1. Introduction The prognosis of the newly diagnosed breast cancer patient depends on a number of factors, among the most important of which is the extent of spread of disease to the axillary lymph nodes [1, 2]. Because treatment is influenced by the presence and number of axillary lymph nodes involved, evaluation of the axillary nodes has been performed in every patient that could tolerate it after a diagnosis of invasive carcinoma [3]. In the past, a complete surgical dissection of the axilla was performed, resulting in significant morbidity, including a 30% incidence of lymphedema [4]. The development of sentinel node mapping resulted in a notable reduction in morbidity; however, if a sentinel node was positive, often not discovered until final pathologic processing done postoperatively, complete axillary dissection would be performed at a later date to assess the total number of lymph nodes involved, thus requiring a second surgical procedure and anesthesia [5¨C7]. A preoperative diagnosis of axillary metastasis by ultrasound guided node biopsy would streamline patient care and reduce operating room time and expense
%U http://www.hindawi.com/journals/isrn.oncology/2014/703160/