Impact of sentinel lymph node biopsy by ultrasound-guided core needle biopsy for patients with suspicious node positive breast cancer View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-07-22

AUTHORS

Rikiya Nakamura, Naohito Yamamoto, Toshiko Miyaki, Makiko Itami, Nobumitsu Shina, Masayuki Ohtsuka

ABSTRACT

PurposeThe purpose of this study was to investigate the accuracy of preoperative diagnostic tools for axillary lymph nodes (LNs) staging of breast cancer.Materials and MethodsA total of 2464 consecutive patients with operable breast cancer were prospectively identified at our institution between April 2012 and March 2017. Patients with suspicious axillary LN of breast cancer were assessed using preoperative ultrasound(US) or computed tomography (CT), underwent fine-needle aspiration cytology (FNA) or core needle biopsy (CNB). The inclusion criteria for both FNA and CNB were a cortical thickness >3 mm or abnormal morphological characteristics. Patients with biopsy-proven metastasis underwent axillary lymph node dissection (ALND), and those with a negative FNA or CNB underwent sentinel lymph node biopsy (SNB). If the SNB was positive, ALND was performed. Diagnostic accuracy for SNB was calculated for both FNA and CNB. In addition, the patients in this study were divided into two groups as follows: the cN0-FNA group (suspicious LN but negative FNA) and cN0-CNB group (suspicious LN but negative CNB).ResultsA number of patients with negative US/CT findings of LNs were 1406, with 744 undergoing FNA and 272 undergoing CNB for suspicious LNs. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 65, 99, 99, 80, and 85% in FNA, and 87, 100, 100, 93 and 95% in CNB, respectively. SNB was performed in 172 (cN0-CNB group) of 272 CNB and 487 (cN0-FNA group) of 744 FNA patients. One hundred and seventy-two patients from the cN0-CNB group (Tis 6, T1 97, T2 66, T3 3 patients) treated with SNB were compared to 487 from the cN0-FNA group (Tis 21, T1 225, T2 233, T3 8 patients) in terms of number of LN metastasis. A number of patients with more than 3 positive SNB and positive LNs were 9 (5%) and 0 (0%) in cN0-CNB group, and 78 (16%) and 24 (5%) in cN0-FNA group, respectively. A number of patients who had complications such as haematoma and pain at the time of 7 to 14 days after CNB and FNA were 1 (0.5%) and 1 (0.5%) in cN0-CNB group, and were 0% and 0.2% in cN0-FNA group (p = 0.44), respectively.ConclusionsThe preoperative diagnosis of axillary LNs was influenced by the diagnostic tool used. CNB is a reliable method for the preoperative diagnosis of LN metastasis. More... »

PAGES

86-93

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12282-017-0795-7

DOI

http://dx.doi.org/10.1007/s12282-017-0795-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1090867652

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28735457


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34 schema:description PurposeThe purpose of this study was to investigate the accuracy of preoperative diagnostic tools for axillary lymph nodes (LNs) staging of breast cancer.Materials and MethodsA total of 2464 consecutive patients with operable breast cancer were prospectively identified at our institution between April 2012 and March 2017. Patients with suspicious axillary LN of breast cancer were assessed using preoperative ultrasound(US) or computed tomography (CT), underwent fine-needle aspiration cytology (FNA) or core needle biopsy (CNB). The inclusion criteria for both FNA and CNB were a cortical thickness >3 mm or abnormal morphological characteristics. Patients with biopsy-proven metastasis underwent axillary lymph node dissection (ALND), and those with a negative FNA or CNB underwent sentinel lymph node biopsy (SNB). If the SNB was positive, ALND was performed. Diagnostic accuracy for SNB was calculated for both FNA and CNB. In addition, the patients in this study were divided into two groups as follows: the cN0-FNA group (suspicious LN but negative FNA) and cN0-CNB group (suspicious LN but negative CNB).ResultsA number of patients with negative US/CT findings of LNs were 1406, with 744 undergoing FNA and 272 undergoing CNB for suspicious LNs. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 65, 99, 99, 80, and 85% in FNA, and 87, 100, 100, 93 and 95% in CNB, respectively. SNB was performed in 172 (cN0-CNB group) of 272 CNB and 487 (cN0-FNA group) of 744 FNA patients. One hundred and seventy-two patients from the cN0-CNB group (Tis 6, T1 97, T2 66, T3 3 patients) treated with SNB were compared to 487 from the cN0-FNA group (Tis 21, T1 225, T2 233, T3 8 patients) in terms of number of LN metastasis. A number of patients with more than 3 positive SNB and positive LNs were 9 (5%) and 0 (0%) in cN0-CNB group, and 78 (16%) and 24 (5%) in cN0-FNA group, respectively. A number of patients who had complications such as haematoma and pain at the time of 7 to 14 days after CNB and FNA were 1 (0.5%) and 1 (0.5%) in cN0-CNB group, and were 0% and 0.2% in cN0-FNA group (p = 0.44), respectively.ConclusionsThe preoperative diagnosis of axillary LNs was influenced by the diagnostic tool used. CNB is a reliable method for the preoperative diagnosis of LN metastasis.
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41 FNA patients
42 LN metastasis
43 LNs
44 Ln
45 PurposeThe purpose
46 abnormal morphological characteristics
47 accuracy
48 addition
49 aspiration cytology
50 axillary LN
51 axillary LNs
52 axillary lymph node dissection
53 axillary lymph node staging
54 biopsy
55 breast cancer
56 cancer
57 characteristics
58 complications
59 consecutive patients
60 core needle biopsy
61 cortical thickness
62 cytology
63 days
64 diagnosis
65 diagnostic accuracy
66 diagnostic tool
67 dissection
68 findings
69 fine needle aspiration cytology
70 group
71 haematoma
72 impact
73 inclusion
74 institutions
75 lymph
76 lymph node biopsy
77 lymph node dissection
78 lymph node staging
79 materials
80 metastasis
81 method
82 morphological characteristics
83 needle biopsy
84 negative fine-needle aspiration cytology
85 negative predictive value
86 node biopsy
87 node dissection
88 node staging
89 node-positive breast cancer
90 number
91 number of patients
92 operable breast cancer
93 pain
94 patients
95 positive LNs
96 positive breast cancer
97 positive predictive value
98 positive sentinel lymph node biopsy
99 predictive value
100 preoperative diagnosis
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102 purpose
103 reliable method
104 sensitivity
105 sentinel lymph
106 sentinel lymph node biopsy
107 specificity
108 staging
109 study
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111 terms
112 terms of number
113 thickness
114 time
115 tomography
116 tool
117 total
118 ultrasound-guided core needle biopsy
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