Rol de la ecografía y punción con aguja fina en el manejo de la axila en pacientes con cáncer mamario, en la era posterior al ACOSOG Z0011

Febles, Gustavo; Dell’Acqua, Andrés; Cristiani, Andrea; Balbiani, Cristina; Bergeret, Frances

doi:10.1016/j.senol.2018.07.002

Cited by 1 publication

(1 citation statement)

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“…With this practice, greater precision is achieved in the selection of patients for SNB or axillary lymph node dissection (ALND). [3][4][5][6][7][8] In this evolution regarding the concepts related to the management of the axilla in breast cancer, it is necessary to highlight the publication of study Z0011 by the American College of Surgeons Oncology Group (ACOSOG) in 2011. 9 The study analyzed patients with T1 and T2 tumors, clinically negative axilla and SNB with a result of up to 2 nodes with macrometastases, treated with conservative surgery and whole-breast radiotherapy.…”

Section: Introductionmentioning

confidence: 99%

The Current Status of Ultrasonography and Fine-Needle Aspiration Citology for the Management of the Axilla in Breast Cancer

De León,

Dell´Acqua,

Cristiani

2023

MRAJ

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Objetive: to analyze whether ultrasonography with fine-needle aspiration cytology of an axillary suspicious node, in patients with breast cancer, could help to differentiate between patients with low involvement of the axilla (up to 2 nodes with macrometastasis) of those with high involvement of the axilla (more than 2 lymph nodes with macrometastasis). Material and methods: A total of 115 consecutive patients with breast cancer (up to 5 cm in diameter), with clinically negative axilla and pathologically positive axilla. All patients underwent preoperative axillary ultrasound and ultrasound-guided fine-needle aspiration cytology was performed in patients with suspicious nodes. In all patients with positive cytology, lymphadenectomy was performed. In all patients with negative ultrasound and cytology, sentinel lymph node biopsy was performed, and when it was positive, lymphadenectomy was performed. The number of pathological lymph nodes was evaluated after lymphadenectomy. Results: A total of 61 patients had positive axillary ultrasound and cytology. In 42 of them (69%), there were more than 2 pathological lymph nodes. There were 54 patients with negative axillary ultrasound and cytology. In 49 of them (90%), there were only 1 or 2 pathological lymph nodes. Axillary ultrasound and fine-needle aspiration cytology were able to identify 42 of the 47 patients (89%) with more than 2 pathological lymph nodes. Conclusion: ultrasound and ultrasound-guided fine-needle aspiration citology was able to identify, in a preoperative stage, those patients with high axillary involvement (more than 2 lymph nodes with macrometastasis). The latter are the patients who would benefit from lymphadenectomy of the axilla, ignoring the sentinel lymph node biopsy stage.

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