Fine-needle aspiration cytology versus core needle lymph node biopsy in axillary staging of breast cancer

Abstract

Background Axillary lymph node status is an extremely important prognostic factor in evaluating and managing recently diagnosed breast cancer patients. So, preoperative evaluation of the lymph nodes in breast cancer patients with minimally invasive methods is of significant concern. Ultrasonography is the main modality used for this purpose, with advantages including the ability to help to guide the biopsy. This study aimed to compare ultrasound-guided fine-needle aspiration cytology (FNAC) and core needle biopsy (CNB) in their ability to detect metastatic disease in the axillary lymph nodes, as well as to estimate the accuracy of preoperative ultrasound-guided axillary lymph node biopsy for staging in patients with breast cancer. Results In total, 108 cases were included in the study, and 55.6% (60 cases) had metastases. The sensitivity for FNAC was 83.3%, and the specificity was 100%. The sensitivity for CNB was 100% and the specificity was 100%. The negative predictive value for FNAC was 81.5%, and that for CNB was 100%. The positive predictive value was 100% for both methods. Conclusions CNB biopsy shows higher sensitivity and accuracy than FNAC in the characterization of benign and malignant lymph nodes. FNAC is a suitable substitute when a smaller node is encountered, a node in an inaccessible site, or even an uncorrectable bleeding diathesis of the patient.

Diagnostic Accuracy of Elastography to Differentiate Between Malignant and Benign Lymph Nodes of Neck and Head Region Taking Histopathology as Gold Standard

“…Mahmoud et al reported the principle on which the real-time USE is grounded that is under compression the harder or rigid parts of the tissues take more time in deforming as compared to the softer ones, which allows determining the maximum diameter of tissues with the help of conventional ultrasound showing indeterminate results. A 4-5 elasticity score of malignancy was highly predictive with an accuracy, specificity, and sensitivity of 90.20%, 89.47%, and 90.63%, respectively 24 .…”

Evaluating Different Quantitative Shear Wave Parameters of Ultrasound Elastography in the Diagnosis of Lymph Node Malignancies: A Systematic Review and Meta-Analysis

“…Different gold standards carry different diagnostic accuracies in determining LN malignancy. For example, studies have suggested that CNB has higher sensitivity than FNAC (87–100% and 74–83.3%, respectively), without significant differences in specificities (96–100% and 98–100%, respectively) [ 55 , 56 , 57 ]. When compared with surgical biopsy, CNB showed a lower sensitivity at 90% than its specificity at 100% due to false negative cases, and an LN biopsy is recommended in cases of suspected neoplasms [ 58 , 59 ].…”

“…When compared with surgical biopsy, CNB showed a lower sensitivity at 90% than its specificity at 100% due to false negative cases, and an LN biopsy is recommended in cases of suspected neoplasms [ 58 , 59 ]. In malignancies such as lymphoma, CNB is often preferred over FNAC, mainly to preserve the tissue or nodal architecture to enable comprehensive histopathological review and diagnosis [ 55 , 56 , 57 ]. In head and neck squamous cell cancers, FNAC are deemed to be adequate in making a diagnosis in certain cases [ 58 , 59 ].…”

Sonographic evaluation of axillary lymph node status in newly diagnosed breast cancer patients: A prospective study

“…Sonography can detect metastasis in ALNs based on the morphological characteristics of normal and suspicious LNs [14][15][16]. Furthermore, it is critical in guiding biopsies, such as ne-needle aspiration biopsy (FNAB) and/or core-needle biopsy (CNB), of suspicious lymph nodes to con rm the presence of metastases, which affects the management plans [17,18]. Numerous studies have been conducted in adjacent countries and around the world to evaluate the accuracy and use of sonography in diagnosing lymph node metastases, with sensitivity and speci city ranging from 55-95% [5,14,19].…”