Jung Hyun Yoon MD, Presenter: Nothing to Disclose

Min Jung Kim MD, Abstract Co-Author: Nothing to Disclose

Eun-Kyung Kim, Abstract Co-Author: Nothing to Disclose

Hee Jung Moon MD, Abstract Co-Author: Nothing to Disclose

To evaluate whether concentrations of tumor marker CYFRA show significance compared to CEA and CA15-3 in the preoperative differential diagnosis of axillary lymph node metastasis (ALNM) using ultrasonography-guided fine-needle aspiration biopsy (US-FNAB) in breast cancer patients.

An Institutional Review Board approved of this study, and informed consent was obtained from the patients. From March 2008 to July 2010, US-FNAB was performed in 156 ALNs in 152 women (mean age: 51.4 years, range: 17-92 years) diagnosed with breast cancer. After obtaining FNA specimen, the syringe used in aspiration was rinsed in 1mL of normal saline. Concentrations of CEA, CA15-3, and CYFRA were measured individually from these washouts. Diagnostic performances of US-FNAB alone and in combination with each tumor marker were calculated and compared for analysis.

Among the 156 LNs, 75 (48.1%) were benign, and 81 (51.9%) were metastases. Patients with ALNM showed significantly higher concentrations of CEA (P= 0.028) and CYFRA (P< 0.001). Compared to US-FNAB alone, US-FNAB combined with CEA and CA15-3 either did not show significant differences or declined compared to the sensitivity, accuracy and Az value of US-FNAB alone; 83.2%, 82.7% to 79.0% (P= 0.151 and 0.040), 89.7%, 83.3% to 89.1% (P= 0.196 and 0.043), and 0.901, 0.833 to 0.895 (P= 0.252 and 0.064), respectively. US-FNAB combined with CYFRA showed highest sensitivity, accuracy, and Az value compared to US-FNAB alone; 91.1% to 79.0% (P= 0.001), 93.6% to 89.1% (P= 0.001), and 0.937 to 0.895 (P= 0.153), respectively.

US-FNAB combined with CYFRA shows significantly higher sensitivity and accuracy to US-FNAB alone in the preoperative diagnosis of ALNM in breast cancer patients.

US-FNAB combined with various tumor markers can improve diagnostic accuracy in ALNM of breast cancer patients.

Yoon, J, Kim, M, Kim, E, Moon, H, Role of Tumor Markers in Preoperative Diagnosis of Axillary Lymph Node Metastasis in Breast Cancer: Comparison of CEA, CA15-3, and CYFRA in Fine Needle Aspirates.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11013296.html