Eugenio Zanon MD, Presenter: Nothing to Disclose

Mauro Drogo MD, Abstract Co-Author: Nothing to Disclose

Chiara Gallino MD, Abstract Co-Author: Nothing to Disclose

Rosanna Gallo MD, Abstract Co-Author: Nothing to Disclose

Carla Gilardi MD, Abstract Co-Author: Nothing to Disclose

Simona Morello MD, Abstract Co-Author: Nothing to Disclose

Axillary nodal status is an important factor to evaluate in patients with breast cancer in order to plan surgical treatment. This is even more important now due to the increased indications to perform SLND (Sentinel Lymph-Node Dissection). Aim of the present work is to evaluate the role of ultrasound and ultrasonographically (US)- guided Fine-Needle Aspiration Biopsy (FNAB) in the diagnosis of metastatic axillary lymph-nodes in patients with suspicious breast cancer or nodal recurrence after breast cancer surgery.

From 1998 to 2005 410 US-guided FNAB of axillary lymph-nodes have been performed. Selection criteria included patients with suspicious breast cancer, nodal recurrence after breast cancer surgery and presence of suspicious axillary lymph-node at US without known primary breast cancer. All patients underwent axillary ultrasound during the same breast examination session; all the cases with at least one suspicious lymph-node underwent FNAB.

In our series, 164/410 (39.8%) FNAB were positive for metastases, 228/410 (55.8%) were negative and 18/410 (4.4%) were non informative. All the 164 positive cases underwent axillary surgical dissection and were confirmed to be metastatic. Of the 246 benign or non informative samples, 206 underwent SLND dissection and 40 were sent for follow up. In 43/206 of SLND cases metastatic cells were found at surgery, while 163/206 cases were negative.

FNAB of suspicious axillary lymph-nodes is effective in order to predict metastatic involvement in patients with breast cancer. Patients with positive FNAB should be considered as metastatic in order to plan treatment.

Axillary US should be performed before treatment in patients with breast cancer. All cases with suspicious axillary lymph-node(s) should undergo US-guided FNAB. Patients with metastatic involvement proven by FNAB should proceed directly to axillary dissection or adjuvant chemotherapy, thus avoiding SLND. Patients with negative FNAB should undergo SLND when indicated.

Zanon, E, Drogo, M, Gallino, C, Gallo, R, Gilardi, C, Morello, S, Ultrasound and FNAB (Fine Needle Aspiration Biopsy) of Axillary Lymph Nodes: Role in the Management of Breast Cancer.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4430768.html