Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging

Akinci, Muzaffer; Erözgen, Fazilet; GÜLEN, Mehmet; Kocakusak, Ahmet; Gülşen, Gökçe; KAPLAN, Rafet; GÜRBÜZEL, Mihriban; PAMAK BULUT, SERAP

Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging

Muzaffer AKINCI, (Haseki Eğitim ve Araştırma Hastanesi, Genel Cerrahi Kliniği, İstanbul, Türkiye)

SERAP PAMAK BULUT, (Haseki Eğitim ve Araştırma Hastanesi, Genel Cerrahi Kliniği, İstanbul, Türkiye)

Fazilet ERÖZGEN, (Haseki Eğitim ve Araştırma Hastanesi, Genel Cerrahi Kliniği, İstanbul, Türkiye)

Mihriban GÜRBÜZEL, (Haseki Eğitim Hastanesi, Patoloji Kliniği, İstanbul, Türkiye)

Gökçe GÜLŞEN, (Haseki Eğitim ve Araştırma Hastanesi, Radyoloji Kliniği, İstanbul, Türkiye)

Ahmet KOCAKUŞAK, (Haseki Eğitim ve Araştırma Hastanesi, Genel Cerrahi Kliniği, İstanbul, Türkiye)

Mehmet GÜLEN, (Haseki Eğitim ve Araştırma Hastanesi, Genel Cerrahi Kliniği, İstanbul, Türkiye)

Rafet KAPLAN (Haseki Eğitim ve Araştırma Hastanesi, Genel Cerrahi Kliniği, İstanbul, Türkiye)

Ulusal Cerrahi Dergisi

0 0

Yıl: 2016 Cilt: 32 Sayı: 3 Sayfa Aralığı: 191 - 196 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022

Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging

Öz:

Objective: Diagnosis of axillary nodal involvement is significant in the management of breast cancer as well asin predicting prognosis. In this prospective study, we evaluated the efficiency of US-guided fine needle aspirationbiopsy (FNAB) in preoperative axillary staging of early breast cancer.Material and Methods: Between January 2011 and July 2013, 46 women were prospectively enrolled in the study.Ultrasound guided-FNABs for axillary assessment were performed preoperatively. Cytology results were compared withhistopathology reports to determine its sensitivity, specificity, negative and positive predictive value and accuracy.Results: Nineteen cases that had malignant cytology on FNAB also had axillary involvement in axillary lymph nodedissection (ALND) without any false-positive results. The sensitivity and specificity of US-guided FNAB were 63.3% and100%, respectively. US-guided FNAB was accurate in predicting the status of the axilla in 76.1% of patients.Conclusion: Although this technique is favorable due to its minimally invasive nature, it is not as effective as sentinellymph node biopsy (SLNB) in terms of detecting axillary metastasis preoperatively. The low sensitivity and lowaccuracy rates decrease the usefulness of the technique. Therefore, it seems that US-guided FNAB alone could notreplace SLNB. Nevertheless, combining some other molecular studies may be useful in increasing the technique’ssensitivity. These issues should be determined by comprehensive clinical trials.Keywords: Breast cancer, axillary ultrasound, axillary staging, axillary lymph node sampling, axillary fine-needleaspiration biopsy

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Rao R, Euhus D, Mayo HG, Balch C. Axillary node interventions in breast cancer: a systematic review. JAMA 2013; 310: 1385-1394. [CrossRef]
2. Selcuk S, Zalluhoglu N, Gurkan A, Kacar S, Kilic S, Karaca C, et al. Effect of breast preserving surgery in the treatment of early breast cancer (retrospective analysis). Ulus Cerrahi Derg 2005; 21: 135- 140.
3. Purushotham AD, Upponi S, Klevesath MB, Bobrow L, Millar K, Myles JP, et al. Morbidity after sentinel lymph node biopsy in primary breast cancer: results from a randomized controlled trial. J Clin Oncol 2005; 23: 4312-4321. [CrossRef]
4. Verbanck J, Vandewiele I, De Winter H, Tytgat J, Van Aelst Tanghe W. Value of axillary ultrasonography and sonographically guided puncture of axillary nodes: A prospective study in 144 consecutive patients. J Clin Ultrasound 1997; 25: 53-56. [CrossRef]
5. Bonnema J, van Geel AN, van Ooijen B, Mali SP, Tjiam SL, Henzen- Logmans SC, et al. Ultrasound-guided aspiration biopsy for detection of nonpalpable axillary node metastases in breast cancer patients: new diagnostic method. World J Surg 1997; 21: 270-274. [CrossRef]
6. Oruwari JU, Chung MA, Koelliker S, Steinhoff MM, Cady B. Axillary staging using ultrasound-guided fine needle aspiration biopsy in locally advanced breast cancer. Am J Surg 2002; 184: 307-309. [CrossRef]
7. Chang MC, Crystal P, Colgan TJ. The evolving role of axillary lymph node fine- needle aspiration in the management of carcinoma of the breast. Cancer Cytopathol 2011; 119: 328-334. [CrossRef]
8. Sahoo S, Sanders M, Roland L, Pile N, Chagpar A. A strategic approach to the evaluation of axillary lymph nodes in breast cancer patients: analysis of 168 patients at a single institution. Am J Surg 2007; 194: 524-526. [CrossRef]
9. Mainiero MB. Regional lymph node staging in breast cancer: The increasing role of imaging and ultrasound-guided axillary lymph node fine needle aspiration. Radiol Clin N Am 2010; 48: 989-997. [CrossRef]
10. Topal U, Pinar S, Tasdelen I, Adim SB. Role of ultrasound-guided core needle biopsy of axillary lymph nodes in the initial staging of breast carcinoma. Eur J Radiol 2005; 56: 382-385. [CrossRef]
11. Lumachi F, Borsato S, Tregnaghi A, Ferretti G, Povolato M, Cecchin D, et al. Usefulness of combined sestamibi scintimammography and FNA cytology in reducing the number of sentinel node procedures in patients with early-stage breast cancer. Anticancer Res 2009; 29: 491-494.
12. Specht MC, Fey JV, Borgen PI, Cody HS. Is the clinically positive axilla in breast cancer really a contraindication to sentinel lymph node biopsy? J Am Coll Surg 2005; 200: 10-14.
13. Caudle AS, Hunt KK, Kuerer HM, Meric-Bernstam F, Lucci A, Bedrosian I, et al. Multidisciplinary considerations in the implementation of the findings from the American College of Surgeons Oncology Group (ACOSOG) Z0011 study: a practice-changing trial. Ann Surg Oncol 2011; 18: 2407-2412. [CrossRef]
14. Tahir M, Osman KA, Shabbir J, Rogers C, Suarez R, Reynolds T, et al. Preoperative axillary staging in breast cancer – saving time and resources. Breast J 2008; 14: 369-371. [CrossRef]
15. Deurloo EE, Tanis PJ, Gilhuijs KG, Muller SH, Kröger R, Peterse JL, et al. Reduction in the number of sentinel lymph node procedures by preoperative ultrasonography of the axilla in breast cancer. Eur J Cancer 2003; 39: 1068-1073. [CrossRef]
16. Gilissen F, Oostenbroek R, Storm R, Westenend P, Plaisier P. Prevention of futile sentinel node procedures in breast cancer: ultrasonography of the axilla and fine-needle aspiration cytology are obligatory. Eur J Surg Oncol 2006; 34: 497-500. [CrossRef]
17. Mainiero MB, Cinelli CM, Koelliker SL, Graves TA, Chung MA. Axillary ultrasound and fine-needle aspiration in the preoperative evaluation of the breast cancer patient : An algorithm based on tumor size and lymph node appearance. AJR 2010; 195: 1261- 1267. [CrossRef]
18. Cools-Lartigue J, Meterissian S. Accuracy of axillary ultrasound in the diagnosis of nodal metastasis in invasive breast cancer: a review. World J Surg 2012; 36: 46-54. [CrossRef]
19. MacNeill M, Arnott I, Thomas J. Fine needle aspiration cytology is a valuable adjunct to axillary ultrasound in the preoperative staging of breast cancer. J Clin Pathol 2011; 64: 42-46. [CrossRef]
20. Popli MB, Sahoo M, Mehrotra N, Choudhury M, Kumar A, Pathania OP, et al. Preoperative ultrasound-guided fine-needle aspiration cytology for axillary staging in breast carcinoma. Australas Radiol 2006; 50: 122-126. [CrossRef]
21. Alvarez S, Ańorbe E, Alcorta P, Lòpez F, Alonso I, Cortės J. Role of sonography in the diagnosis of ancillary lymph node metastases in breast cancer: a systematic review. AJR Am J Roentgenol 2006; 186: 1342-1348. [CrossRef]
22. Koelliker SL, Chung MA, Mainiero MB, Steinhoff MM, Cady B. Axillary lymph nodes: US-guided fine-needle aspiration for initial staging of breast cancer--correlation with primary tumor size. Radiology 2008; 246: 81-89. [CrossRef]
23. van Rijk MC, Deurloo EE, Nieweg OE, Gilhuijs KG, Peterse JL, Rutgers EJ, et al. Ultrasonography and fine-needle aspiration cytology can spare breast cancer patients unnecessary sentinel lymph node biopsy. Ann Surg Oncol 2006; 13: 31-35. [CrossRef]
24. Hinson JL, McGrath P, Moore A, Davis JT, Brill YM, Samoilova E, et al. The critical role of axillary ultrasound and aspiration biopsy in the management of breast cancer patients with clinically negative axilla. Ann Surg Oncol 2008; 15: 250-255. [CrossRef]
25. Ciatto S, Brancato B, Risso G, Ambrogetti D, Bulgaresi P, Maddau C, et al. Accuracy of fine needle aspiration cytology (FNAC) of axillary lymph nodes as a triage test in breast cancer staging. Breast Cancer Res Treat 2007; 103: 85-91. [CrossRef]
26. Alkuwari E, Auger M. Accuracy of fine-needle aspiration cytology of axillary lymph nodes in breast cancer patients: a study of 115 cases with cytologic-histologic correlation. Cancer 2008; 114: 89- 93. [CrossRef]
27. Swinson C, Ravichandran D, Nayagam M, Allen S. Ultrasound and fine needle aspiration cytology of the axilla in the pre-operative identification of axillary nodal involvement in breast cancer. Eur J Surg Oncol 2009; 35: 1152-1157. [CrossRef]
28. Krishnamurthy S, Hynek I, Vasquez S, Hunt KK, Yang W. Utility of ultrasound-guided fine needle aspiration of indeterminate and suspicious axillary lymph nodes in the management of patients with early breast cancer: a study of 278 patients. Cancer Cytopathol 2008; 114: 350.
29. Holwitt DM, Swatske ME, Gillanders WE, Monsees BS, Gao F, Aft RL, et al. Scientific Presentation Award : The combination of axillary ultrasound and ultrasound-guided biopsy is an accurate predictor of axillary stage in clinically node-negative breast cancer patients. Am J Surg 2008; 196: 477-482. [CrossRef]
30. Kuenen-Boumeester V, Menke-Pluymers M, de Kanter AY, Obdeijn IM, Urich D, Van Der Kwast TH. Ultrasound-guided fine needle aspiration cytology of axillary lymph nodes in breast cancer patients. A preoperative staging procedure. Eur J Cancer 2003; 39: 170-174. [CrossRef]
31. Krishnamurthy S, Sneige N, Bedi DG, Edieken BS, Fornage BD, Kuerer HM, et al. Role of ultrasound-guided fine-needle aspiration of indeterminate and suspicious axillary lymph nodes in the initial staging of breast carcinoma. Cancer 2002; 95: 982-988. [CrossRef]
32. Van de Vrande S, Meijer J, Rijinders A, Klinkenbijl JH. The value of intraoperative frozen section examination of sentinel lymph nodes in breast cancer. Eur J Surg Oncol 2009; 35: 276-280. [CrossRef]
33. Celebioğlu F, Sylvan M, Perbeck L, Bergkvist L, Frisell J. Intraoperative sentinel lymph node examination by frozen section, immunhistochemistry and imprint cytology during breast surgery – a prospective study. Eur J Cancer 2006; 42: 617-620. [CrossRef]
34. Pigott J, Nichols R, Maddox WA, Balch CM. Metastases to the upper levels of the axillary nodes in carcinoma of the breast and its implications for nodal sampling procedures. Surg Gynecol Obstet 1984; 158: 255-259.

APA	Akinci M, PAMAK BULUT S, Erözgen F, GÜRBÜZEL M, Gülşen G, Kocakusak A, GÜLEN M, KAPLAN R (2016). Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging. , 191 - 196.
Chicago	Akinci Muzaffer,PAMAK BULUT SERAP,Erözgen Fazilet,GÜRBÜZEL Mihriban,Gülşen Gökçe,Kocakusak Ahmet,GÜLEN Mehmet,KAPLAN Rafet Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging. (2016): 191 - 196.
MLA	Akinci Muzaffer,PAMAK BULUT SERAP,Erözgen Fazilet,GÜRBÜZEL Mihriban,Gülşen Gökçe,Kocakusak Ahmet,GÜLEN Mehmet,KAPLAN Rafet Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging. , 2016, ss.191 - 196.
AMA	Akinci M,PAMAK BULUT S,Erözgen F,GÜRBÜZEL M,Gülşen G,Kocakusak A,GÜLEN M,KAPLAN R Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging. . 2016; 191 - 196.
Vancouver	Akinci M,PAMAK BULUT S,Erözgen F,GÜRBÜZEL M,Gülşen G,Kocakusak A,GÜLEN M,KAPLAN R Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging. . 2016; 191 - 196.
IEEE	Akinci M,PAMAK BULUT S,Erözgen F,GÜRBÜZEL M,Gülşen G,Kocakusak A,GÜLEN M,KAPLAN R "Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging." , ss.191 - 196, 2016.
ISNAD	Akinci, Muzaffer vd. "Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging". (2016), 191-196.

APA	Akinci M, PAMAK BULUT S, Erözgen F, GÜRBÜZEL M, Gülşen G, Kocakusak A, GÜLEN M, KAPLAN R (2016). Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging. Ulusal Cerrahi Dergisi, 32(3), 191 - 196.
Chicago	Akinci Muzaffer,PAMAK BULUT SERAP,Erözgen Fazilet,GÜRBÜZEL Mihriban,Gülşen Gökçe,Kocakusak Ahmet,GÜLEN Mehmet,KAPLAN Rafet Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging. Ulusal Cerrahi Dergisi 32, no.3 (2016): 191 - 196.
MLA	Akinci Muzaffer,PAMAK BULUT SERAP,Erözgen Fazilet,GÜRBÜZEL Mihriban,Gülşen Gökçe,Kocakusak Ahmet,GÜLEN Mehmet,KAPLAN Rafet Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging. Ulusal Cerrahi Dergisi, vol.32, no.3, 2016, ss.191 - 196.
AMA	Akinci M,PAMAK BULUT S,Erözgen F,GÜRBÜZEL M,Gülşen G,Kocakusak A,GÜLEN M,KAPLAN R Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging. Ulusal Cerrahi Dergisi. 2016; 32(3): 191 - 196.
Vancouver	Akinci M,PAMAK BULUT S,Erözgen F,GÜRBÜZEL M,Gülşen G,Kocakusak A,GÜLEN M,KAPLAN R Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging. Ulusal Cerrahi Dergisi. 2016; 32(3): 191 - 196.
IEEE	Akinci M,PAMAK BULUT S,Erözgen F,GÜRBÜZEL M,Gülşen G,Kocakusak A,GÜLEN M,KAPLAN R "Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging." Ulusal Cerrahi Dergisi, 32, ss.191 - 196, 2016.
ISNAD	Akinci, Muzaffer vd. "Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging". Ulusal Cerrahi Dergisi 32/3 (2016), 191-196.