Axillary Lymph Node Echo-Guided Fine-Needle Aspiration Cytology Enables Breast Cancer Patients to Avoid a Sentinel Lymph Node Biopsy. Preliminary Experience and a Review of the Literature

Abstract

This simple, inexpensive, and minimally invasive technique makes it possible to avoid the additional cost of a sentinel lymph node biopsy while also sparing the patient the stress of undergoing a second surgery.

Lymph Node Involvement in Immunohistochemistry-Based Molecular Classifications of Breast Cancer

“…Concurrent with the surgical treatment of their primary breast cancer, the patient would undergo sentinel LN biopsy after chemotherapy [27]. Limitations of this practice include: 1) needle biopsy of a radiographically suspicious axillary LN can have a false-negative result of over 30% [28], and 2) the false-negative rate of sentinel LN biopsies after neoadjuvant chemotherapy is higher at 12% [29] compared to the desirable rate of <5% [30]. False-negative LN results may alter adjuvant systemic treatment recommendations and/or additional recommendations for locoregional control (subsequent axillary lymph node dissection/radiation therapy), potentially impacting care for some patients.…”

Diagnostic Accuracy of Ultrasonograph Guided Fine-needle Aspiration Cytologic in Staging of Axillary Lymph Node Metastasis in Breast Cancer Patients: a Meta-analysis

“…Consequently, 44 articles included information relating FNAC and breast cancer diagnosis. But only 21 of 44 articles satisfied the requirements of the meta-analysis fully (Bonnema et al, 1997;Bedrosian et al, 2003;Deurloo et al, 2003;Kuenen-Boumeester et al, 2003;Sapino et al, 2003;Duchesne et al, 2005;Podkrajsek et al, 2005;Popli et al, 2006;van Rijk et al, 2006;Altomare et al, 2007;Ciatto et al, 2007;Alkuwari et al, 2008;Tahir et al, 2008;Baruah et al, 2010;Jung et al, 2010;Luparia et al, 2010;Carroll et al, 2011;Devaraj et al, 2011;Hayes et al, 2011;Schiettecatte et al, 2011), addressing the value of FNAC in staging of axillary lymph node in breast cancer patients. The detailed procedure was seen in Figure 1.…”

Usefulness of Breast MRI for Safe Omission of Axillary Lymph Nodes Dissection in Sentinel Node-Positive Breast Cancer Patients

“…AFNA is a simple, inexpensive, and minimally invasive technique that makes possible reduction in the numbers of SN biopsies performed [19] [20]. Previous studies have reported that the sensitivity of AFNA was low and the false-negative rate was high [7] [10] [19] [20]. In this study, all patients with AFNA+ findings had metastatic disease at ALND.…”

“…Accuracies of each examination were reported [9], with ultrasound found to be a suitable diagnostic tool for determining lymph node morphologic characteristics in the axilla, and histologic examination of lymph nodes, as well as sonographically guided AFNA [10]. AFNA is a simple, inexpensive, and minimally invasive technique that makes possible reduction in the numbers of SN biopsies performed [19] [20]. Previous studies have reported that the sensitivity of AFNA was low and the false-negative rate was high [7] [10] [19] [20].…”