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

Wang, Xiwen; Xiong, Yun-Hui; Zen, Xiao-Qing; Lin, Haibo; Liu, Qing-Yi

doi:10.7314/apjcp.2012.13.11.5517

Cited by 10 publications

(11 citation statements)

References 44 publications

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“…However, final pathology results supported the performance of both positive US and positive FNAC together (specificity 100% and PPV 100%) as a means to preoperatively determine axillary lymph node involvement. Previous reports have confirmed PPV and specificity at 100% for positive FNAC guided by positive US [ 5 , 11 , 12 , 14 , 17 , 22 ]. Statistical measures of US performance in conjunction with aspiration cytology showed an important supportive role for FNAC in confirming US suspicious axilla.…”

Section: Discussionmentioning

confidence: 75%

Preoperative Assessment of the Axilla by Surgeon Performed Ultrasound and Cytology in Patients With Breast Cancer

et al. 2015

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BackgroundPreoperative evaluation of the axilla, an important prognostic determinant for patients with invasive breast cancer, is achieved by non- or minimally invasive methods to avoid the potential hazards of operative intervention. The aim of this study was to determine statistical power of axillary ultrasound (US) and US-guided fine needle aspiration cytology (FNAC) for evaluating axillary status.MethodsAxillary lymph nodes were imaged for malignant involvement by high resolution US in 93 breast cancer patients with clinically negative axilla. Cytological samples were obtained by US-guided FNAC from image-suspicious lymph nodes. Cytology-positive patients directly underwent axillary lymph node dissection (ALND). Patients with US and/or cytology-negative axilla underwent sentinel lymph node biopsy (SLNB). Using statistical analysis, US findings and US combined with FNAC were compared with SLNB and final pathology to measure performance.ResultsUS was suspicious for metastasis in 38 patients (41%), of whom 16 (42%) were cytology-positive. Axilla was positive in 36/93 patients (38.7%). Sixteen patients with positive FNAC directly underwent ALND. SLNB and/or final pathology was positive in 13/55 patients (23.7%) with negative US (false negative of US) and in 7/22 patients (31.8%) with positive US but negative cytology (false negative of FNAC). SLNB and/or final pathology was negative in 15/38 patients (39.5%) with positive US (false positive of US). Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of US alone were 63.8%, 73.6%, 69.8%, 60.5% and 76.3%, respectively, and 69.6%,100%, 81.6%, 100% and 68.1%, respectively, for US combined with FNAC.ConclusionStatistical measures of the US alone did not achieve a satisfactory value for excluding operative biopsy. US-negative and US-positive but cytology-negative cases still require SLNB for accurate evaluation of axillary status. On the other hand, US-guided positive cytology can obviate SLNB proceeding directly to ALND and avoiding frozen section of sentinel node(s).

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Section: Discussionmentioning

confidence: 75%

Preoperative Assessment of the Axilla by Surgeon Performed Ultrasound and Cytology in Patients With Breast Cancer

et al. 2015

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“…Therefore, a method of stereotactic vacuum-assisted core (SVC) biopsy has come into use for histopathologic diagnosis of these lesions (Tothova et al, 2013). Through the extensive use of mammography in screening for breast cancer, widespread national breast cancer screening programs, and the increase in breast cancer awareness, non-palpable suspicious lesions are being detected more frequently (NHS Breast Screening Programme, 2009;Dogan et al, 2012;Wang et al, 2012;Fouladi et al, 2013;Uyeturk et al, 2013;Avci et al, 2014). Until a few years ago, surgical methods were used for histopathologic evaluation of such lesions that were invisible under ultrasonography.…”

Section: Introductionmentioning

confidence: 99%

Stereotactic Vacuum-Assisted Core Biopsy Results for Non-Palpable Breast Lesions

Agacayak¹,

Ozturk²,

Bozdogan³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: The increase in breast cancer awareness and widespread use of mammographic screening has led to an increased detection of (non-palpable) breast cancers that cannot be discovered through physical examination. One of the methods used in the diagnosis of these cancers is vacuum-assisted core biopsy, which prevents a considerable number of patients from undergoing surgical procedures. The aim of this study was to present the results of stereotactic vacuum-assisted core biopsy for suspicious breast lesions. Materials and Methods: Files were retrospectively scanned and data on demographic, radiological and pathological findings were recorded for patients who underwent stereotactic vacuum-assisted core biopsy due to suspicious mammographic findings at the Interventional Radiology Centre of the Florence Nightingale Hospital between January 2010, and April 2013. Statistical analysis was carried out using Pearson's Chi-square, continuity correction, and Fisher's exact tests. Results: The mean age of the patients was 47 years (range: 36-70). Biopsies were performed due to BIRADS 3 lesions in 8 patients, BIRADS 4 lesions in 77 patients, and BIRADS 5 lesions in 3 patients. Mammography elucidated clusters of microcalcifications in 73 patients (83%) and focal lesions (asymmetrical density, distortion) in 15 patients (17%). In terms of complications, 1 patient had a hematoma, and 2 patients had ecchymoses (3/88; 3.3%). The histopathologic results revealed benign lesions in 63 patients (71.6%) and malignant lesions in 25 patients (28.4%). The mean duration of the procedure was 37 minutes (range: 18-55).Although all of the BIRADS 3 lesions were benign, 22 (28.6%) of the BIRADS 4 lesions and all of the BIRADS 5 lesions were malignant. Among the malignant cases, 80% were in situ, and 20% were invasive carcinomas. These patients underwent surgery. Conclusions: In cases where non-palpable breast lesions are considered to be suspicious in mammography scans, the vacuum-assisted core biopsy method provides an accurate histopathologic diagnosis thus preventing a significant number of patients undergoing unnecessary surgical procedures.

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“…FNAC of breast lumps is an important part of triple assessment (the other two are clinical examination and mammography) of palpable breast lumps (Willems et al, 2012). It is an accurate, rapid, easy to perform, cost-effective and reproducible diagnostic tool (Ahmed et al, 2009;Saleh et al, 2012;Wang et al, 2012;Kochhar et al, 2013). FNAC has sensitivity ranging from 84% to 97.5% and specificity of 99% to 100% for breast lesions (Ogunniyi et al, 1989;Alatise et al, 2006;Nggada et al, 2007;Ahmed et al, 2009;Abdel-Hadi et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Cytomorphologic Patterns of Breast Lesions in Sudanese Patients: Lessons Learned from Fine Needle Aspiration Cytology

Almobarak

Elhassan²,

Elhoweris³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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

Cited by 10 publications

References 44 publications

Preoperative Assessment of the Axilla by Surgeon Performed Ultrasound and Cytology in Patients With Breast Cancer

Preoperative Assessment of the Axilla by Surgeon Performed Ultrasound and Cytology in Patients With Breast Cancer

Stereotactic Vacuum-Assisted Core Biopsy Results for Non-Palpable Breast Lesions

Cytomorphologic Patterns of Breast Lesions in Sudanese Patients: Lessons Learned from Fine Needle Aspiration Cytology

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