False‐negative ultrasound‐guided fine‐needle aspiration of axillary lymph nodes in breast cancer patients

Abstract

Introduction The purpose of this study was to clarify the clinicopathological features of patients with false‐negative fine needle aspiration cytology (FNAC) and to determine the factors associated with negative FNAC. Methods Patients with negative FNAC from January 2010 to December 2019 were included. The patients with positive sentinel nodes (SN) were divided into two groups: micrometastasis (≤2 mm) group and macrometastasis (>2 mm) group. The clinicopathological characteristics were compared between the two groups using the χ2 test. Results A total of 165 patients with negative FNAC were included; 52 (31.5%) had positive SNs. Of the 52 patients, 13 (25%) had micrometastasis and the remaining 39 (75%) had macrometastasis. Of the 113 patients with negative SNs, none had metastases found in non‐SNs. No significant differences were observed in age, cT stage or subtype, and preoperative ultrasound findings between the two groups. Conclusions The false‐negative rate of FNAC was high (31.5%). Micrometastatic disease was seen in patients with negative FNAC, and this might be the cause of false‐negative FNAC results.

Advanced diagnostic imaging of sentinel lymph node in early stage breast cancer

“…45 And it is only one of the factors guiding adjuvant therapy for breast cancer. [44][45][46] TLCEUS has a high sensitivity and specificity for the diagnosis of SLN in breast cancer. It can identify the whole process of contrast agent from tumor to lymphatic drainage to SLNs in a real-time, non-invasive and accurate manner, and has the ability to display metastatic foci in LNs.…”

“…Micrometastasis which is defined as deposits >0.2 to ≤2.0 mm 43 may block the lymphatic vessels inside and outside the SLN, thereby prolonging the arrival time of the contrast agent in the metastatic SLN 42 . Micrometastasis is the main reason for the false negative rate of fine needle aspiration biopsy 44 . Its detection mainly depends on pathological evaluation.…”

“…Studies have shown that the effect of micrometastases on disease‐free survival is very low 45 . And it is only one of the factors guiding adjuvant therapy for breast cancer 44–46 …”

“…42 Micrometastasis is the main reason for the false negative rate of fine needle aspiration biopsy. 44 Its detection mainly depends on pathological evaluation. Studies have shown that the effect of micrometastases on disease‐free survival is very low.…”

Comparison of Cell Blocks and Smear Examination With Fine Needle Aspirates in the Diagnosis of Superficial Palpable Head and Neck Lesions

“…It is well tolerated by the patients and is a cosmetically 10 acceptable method. However, at times, FNAC yields non-diagnostic smears and one is at the risk of making indeterminate 11,12 or false positive/negative diagnoses.…”