Pre-operative Axillary Ultrasound-Guided Needle Sampling in Breast Cancer: Comparing the Sensitivity of Fine Needle Aspiration Cytology and Core Needle Biopsy

Topps, Ashley; Barr, Simon; Pikoulas, Panagiotis; Pritchard, Sheila; Maxwell, Anthony

doi:10.1245/s10434-017-6090-1

Cited by 18 publications

(9 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There was no significant difference between the methodology of the preoperative assessments. Some studies reported an improved diagnostic accuracy of CNB compared to US-FNAC [ 84 , 85 , 86 ]. The sensitivity of CNB was higher than in US-FNAC (0.849 vs. 0.760).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Fine-Needle Aspiration Cytology and Core-Needle Biopsy in the Assessment of the Axillary Lymph Nodes in Breast Cancer—A Meta-Analysis

et al. 2020

View full text Add to dashboard Cite

Background: The present study aims to evaluate the diagnostic accuracy between ultrasonography-guided fine-needle aspiration cytology (US-FNAC) and core needle biopsy (CNB) of axillary lymph nodes (ALNs) in patients with breast cancer through a meta-analysis and a diagnostic test accuracy (DTA) review. Methods: The present meta-analysis and DTA review included 67 eligible studies. The diagnostic accuracy of various preoperative assessments, including US-FNAC and CNB, was evaluated for ALNs assessments in patients with breast cancer. In addition, a subgroup analysis based on methods of cytologic preparation was performed. In the DTA review, the sensitivity, specificity, diagnostic odds ratio (OR) and area under the curve (AUC) on the summary receiver operating characteristic (SROC) curve were calculated. Results: The diagnostic accuracy of the preoperative assessments of ALNs was 0.850 (95% confidence interval (CI) 0.833–0.866) for patients with breast cancer. The diagnostic accuracy of CNB was significantly higher than that of US-FNAC (0.896, 95% CI 0.844–0.932 vs. 0.844, 95% CI 0.825–0.862; p = 0.044 in a meta-regression test). In the subgroup analysis based on cytologic preparation, the diagnosis accuracies were 0.860, 0.861 and 0.859 for the methods of conventional smear, liquid-based preparation and cell block, respectively. In the DTA review, CNB showed higher sensitivity than US-FNAC (0.849 vs. 0.760). However, there was no difference in specificity between US-FNAC and CNB (0.997 vs. 1.000). US-FNAC with liquid-based preparation and CNB showed the highest diagnostic OR and AUC on the SROC, respectively. Conclusion: Both US-FNAC and CNB are useful in preoperative assessments of ALNs in patients with breast cancer. Although the most sensitive test was found to be CNB in this study, there was no difference in specificity between various preoperative evaluations and the application of US-FNAC or CNB may be impacted by various factors.

show abstract

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Fine-Needle Aspiration Cytology and Core-Needle Biopsy in the Assessment of the Axillary Lymph Nodes in Breast Cancer—A Meta-Analysis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…[5][6][7] From these reports, CNB provided high sensitivity and low false-negative rate. [5][6][7] From these reports, CNB provided high sensitivity and low false-negative rate.…”

Section: Introductionmentioning

confidence: 91%

“…Recent studies have shown that core needle biopsy (CNB) is superior diagnostic procedure to FNAC for axillary staging in breast cancer. [5][6][7] From these reports, CNB provided high sensitivity and low false-negative rate. However, complications were more frequently reported CNB than FNAC.…”

Section: Introductionmentioning

confidence: 91%

Ultrasound‐guided fine‐needle aspiration of axillary lymph nodes in breast cancer: Diagnostic accuracy and role in surgical management

Iwamoto

Aruga

Horiguchi

et al. 2019

Diagnostic Cytopathology

View full text Add to dashboard Cite

Background: The objective of this study was to evaluate the accuracy of fine needle aspiration cytology (FNAC) of axillary lymph nodes (LN) in breast cancer, to compare the results of FNAC and pathological examination, and to distinguish patients with 1 to 2 metastatic LNs from those with ≥3 metastatic LNs in patients with FNAC-positive patients. Patients and Methods: This study included 198 breasts of 196 patients with breast cancer who underwent FNAC and surgery for the primary and axilla without neoadjuvant chemotherapy from January 2010 to August 2016. Axillary nodal status was assessed by ultrasound (US), and whether FNAC-positive had three or more suspicious LNs on US imaging was examined. Results: The results of FNAC were positive in 75 (38%), negative in 97 (49%), suspicious in 2 (1%), indeterminate in 5 (2.5%), and insufficient in 19 patients (9.5%). FNAC sensitivity, specificity, positive predictive value, and negative predictive value were 62.6%, 100%, 100%, and 62.0%, respectively. Whereas 53% (18/34) of patients with false-negative FNAC had one metastatic LN on final pathology, 61% (47/77) patients who were FNACpositive had three or more metastatic LNs. In the FNAC-positive patients, all patients had ≥3 metastatic LNs if they had ≥3 suspicious LNs on US imaging. Conclusion: Patients with positive cytology were more likely to have ≥3 positive LNs compared to false-negative cytology patients. Patients with ≥3 abnormal LNs on US and positive FNAC might require axillary dissection.

show abstract

“…The reported false-negative rate of FNAC ranges from 13% to 39%, [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] although the results vary depending on the inclusion criteria. The common causes of false-negative FNAC cases include small-sized metastases.…”

Section: Ta B L E 3 Ultrasound Findings Of the Micrometastasis And Mamentioning

confidence: 99%

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

et al. 2020

View full text Add to dashboard Cite

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.

show abstract

Pre-operative Axillary Ultrasound-Guided Needle Sampling in Breast Cancer: Comparing the Sensitivity of Fine Needle Aspiration Cytology and Core Needle Biopsy

Abstract: CNB is safe and should be the preferred technique for UNS to improve sensitivity.

Cited by 18 publications

References 17 publications

Diagnostic Accuracy of Fine-Needle Aspiration Cytology and Core-Needle Biopsy in the Assessment of the Axillary Lymph Nodes in Breast Cancer—A Meta-Analysis

Diagnostic Accuracy of Fine-Needle Aspiration Cytology and Core-Needle Biopsy in the Assessment of the Axillary Lymph Nodes in Breast Cancer—A Meta-Analysis

Ultrasound‐guided fine‐needle aspiration of axillary lymph nodes in breast cancer: Diagnostic accuracy and role in surgical management

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

Contact Info

Product

Resources

About