Adam Tunis BSC, MSC, Presenter: Nothing to Disclose

Frederick Robert Karl Matzinger MD, Abstract Co-Author: Nothing to Disclose

Jean Seely MD, Abstract Co-Author: Nothing to Disclose

Ultrasound (US) of axillary lymph nodes and US guided needle biopsy may confirm the presence of nodal metastases and thus obviate the need for sentinel lymph node procedures (SLNP). We perform a retrospective comparison of the diagnostic yield of US guided fine needle aspiration (FNA) and core needle biopsy (CNB) in newly diagnosed breast cancer patients.

Of 500 patients who underwent US guided axillary node sampling at a comprehensive breast health center between Jan 1,2003-Dec 31,2006, we identified 159 women who met the following inclusion criteria: biopsy of ipsilateral axillary lymph nodes in newly diagnosed breast cancer; no neoadjuvant chemotherapy or radiation therapy; and surgical treatment with either SLNP or axillary lymph node dissection (ALND). These 159 patients formed the study group of whom 116 underwent FNA and 43 had CNB of the axillary lymph nodes. The gold standard for axillary lymph node metastatic status was considered to be one or more nodes positive via either SLNP or ALND at the time of breast surgery.

CNB had higher overall sensitivity than FNA (91.9% vs. 71.1%, p=0.0035). There was no significant difference in specificity, positive or negative predictive values. Subgroup analyses by tumor grade (modified Scarff-Bloom-Richardson grade), tumor size and nodal morphology (presence or absence of a fatty hilum) also showed higher sensitivity and accuracy for CNB.

US guided CNB of axillary lymph nodes in breast cancer patients has greater sensitivity and accuracy than FNA for identifying nodal tumor spread.

US guided CNB of axillary lymph nodes may identify nodal metastases and obviate the need for sentinel lymph node procedures.

Tunis, A, Matzinger, F, Seely, J, Retrospective Comparison of Fine-Needle Aspiration and Core Needle Biopsy of Axillary Lymph Nodes in Breast Cancer Patients.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6010813.html