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Pre-operative axillary staging: should core biopsy be preferred to fine needle aspiration cytology?
OBJECTIVE: To determine the diagnostic accuracy of ultrasound guided fine needle aspiration (FNA) cytology and core needle biopsy (CNB) of axillary lymph nodes pre-operatively in newly diagnosed operable primary breast cancer. METHODS: An observational study for all patients who underwent pre-operat...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cancer Intelligence
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5365337/ https://www.ncbi.nlm.nih.gov/pubmed/28386294 http://dx.doi.org/10.3332/ecancer.2017.724 |
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author | Vidya, Raghavan Iqbal, Fahad Mujtaba Bickley, Bernadette |
author_facet | Vidya, Raghavan Iqbal, Fahad Mujtaba Bickley, Bernadette |
author_sort | Vidya, Raghavan |
collection | PubMed |
description | OBJECTIVE: To determine the diagnostic accuracy of ultrasound guided fine needle aspiration (FNA) cytology and core needle biopsy (CNB) of axillary lymph nodes pre-operatively in newly diagnosed operable primary breast cancer. METHODS: An observational study for all patients who underwent pre-operative FNA cytology or CNB during September 2013–August 2014 was conducted at our institution (County Hospital, Stafford, UK). The accuracy of pre-operative axillary staging was compared to the post-operative histology. For this sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were calculated. RESULTS: A total of 81 consecutive patients were evaluated by axillary ultrasound. Patients identified with potentially abnormal axillary lymph nodes underwent definitive surgery. Seven patients had positive cytology/histology who did not undergo definitive surgery and were excluded (N = 74) from the study. CNB had a sensitivity of 100% versus 72% (p = 0.006) for FNA cytology. Both had 100% specificity and PPV. The NPV of CNB was 100% versus 72% for FNA cytology. Among 35% of patients that underwent FNA cytology required repeat procedure versus 2.6% of patients who underwent CNB. 0/38 patients that had CNB required a second operation while 7/43 patients with negative FNA cytology had positive lymph nodes identified at sentinel lymph node biopsy (SLNB) requiring surgical re-intervention with axillary node clearance. CONCLUSION: CNB was superior to FNA cytology when interrogating the axilla. We recommend CNB to be adopted routinely in pre-operative axillary staging to reduce surgical re-intervention. |
format | Online Article Text |
id | pubmed-5365337 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Cancer Intelligence |
record_format | MEDLINE/PubMed |
spelling | pubmed-53653372017-04-06 Pre-operative axillary staging: should core biopsy be preferred to fine needle aspiration cytology? Vidya, Raghavan Iqbal, Fahad Mujtaba Bickley, Bernadette Ecancermedicalscience Clinical Study OBJECTIVE: To determine the diagnostic accuracy of ultrasound guided fine needle aspiration (FNA) cytology and core needle biopsy (CNB) of axillary lymph nodes pre-operatively in newly diagnosed operable primary breast cancer. METHODS: An observational study for all patients who underwent pre-operative FNA cytology or CNB during September 2013–August 2014 was conducted at our institution (County Hospital, Stafford, UK). The accuracy of pre-operative axillary staging was compared to the post-operative histology. For this sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were calculated. RESULTS: A total of 81 consecutive patients were evaluated by axillary ultrasound. Patients identified with potentially abnormal axillary lymph nodes underwent definitive surgery. Seven patients had positive cytology/histology who did not undergo definitive surgery and were excluded (N = 74) from the study. CNB had a sensitivity of 100% versus 72% (p = 0.006) for FNA cytology. Both had 100% specificity and PPV. The NPV of CNB was 100% versus 72% for FNA cytology. Among 35% of patients that underwent FNA cytology required repeat procedure versus 2.6% of patients who underwent CNB. 0/38 patients that had CNB required a second operation while 7/43 patients with negative FNA cytology had positive lymph nodes identified at sentinel lymph node biopsy (SLNB) requiring surgical re-intervention with axillary node clearance. CONCLUSION: CNB was superior to FNA cytology when interrogating the axilla. We recommend CNB to be adopted routinely in pre-operative axillary staging to reduce surgical re-intervention. Cancer Intelligence 2017-03-07 /pmc/articles/PMC5365337/ /pubmed/28386294 http://dx.doi.org/10.3332/ecancer.2017.724 Text en © the authors; licensee ecancermedicalscience. http://creativecommons.org/licenses/by/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Study Vidya, Raghavan Iqbal, Fahad Mujtaba Bickley, Bernadette Pre-operative axillary staging: should core biopsy be preferred to fine needle aspiration cytology? |
title | Pre-operative axillary staging: should core biopsy be preferred to fine needle aspiration cytology? |
title_full | Pre-operative axillary staging: should core biopsy be preferred to fine needle aspiration cytology? |
title_fullStr | Pre-operative axillary staging: should core biopsy be preferred to fine needle aspiration cytology? |
title_full_unstemmed | Pre-operative axillary staging: should core biopsy be preferred to fine needle aspiration cytology? |
title_short | Pre-operative axillary staging: should core biopsy be preferred to fine needle aspiration cytology? |
title_sort | pre-operative axillary staging: should core biopsy be preferred to fine needle aspiration cytology? |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5365337/ https://www.ncbi.nlm.nih.gov/pubmed/28386294 http://dx.doi.org/10.3332/ecancer.2017.724 |
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