Punção aspirativa de linfonodo axilar guiada pela ultrassonografia é eficaz como método de predição de acometimento linfonodal em pacientes com câncer de mama?

Pessoa, Eduardo Carvalho; Rodrigues, José Ricardo Paciência; Pessoa, Carla Priscila Kamiya Carvalho; Uemura, Gilberto

doi:10.1590/s0100-72032014000300005

Cited by 4 publications

(2 citation statements)

References 27 publications

(34 reference statements)

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“…The Brazilian radiological literature has recently demonstrated interest on the sonographic evaluation of axillary lymph nodes ( 18 ) , mainly whether US-FNA is an effective method to predict lymph node compromising in breast cancer patients ( 19 ) . Although the utilization of axillary US in association with fine needle aspiration is capable of avoiding a great number SLNB, there is no consensus about when it should be indicated.…”

Section: Discussionmentioning

confidence: 99%

Axillary ultrasound and fine-needle aspiration in preoperative staging of axillary lymph nodes in patients with invasive breast cancer

et al. 2015

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ObjectiveTo propose an algorithm to determine the necessity for ultrasonography-guided fine-needle aspiration (US-FNA) in preoperative axillary lymph node staging of patients with invasive breast cancer.Materials and MethodsProspective study developed at National Cancer Institute. The study sample included 100 female patients with breast cancer referred for axillary staging by US-FNA.ResultsThe overall US-FNA sensitivity was set at 79.4%. The positive predictive value was calculated to be 100%, and the negative predictive value, 69.5%. The US-FNA sensitivity for lymph nodes with normal sonographic features was 0%, while for indeterminate lymph nodes it was 80% and, for suspicious lymph nodes, 90.5%. In the assessment of invasive breast tumors stages T1, T2 and T3, the sensitivity was respectively 69.6%, 83.7% and 100%. US-FNA could avoid sentinel node biopsy in 54% of cases.ConclusionAxillary ultrasonography should be included in the preoperative staging of all patients with invasive breast cancer. The addition of US-FNA in cases of lymph nodes suspicious for malignancy may prevent more than 50% of sentinel lymphadenectomies, significantly shortening the time interval to definitive therapy.

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Section: Discussionmentioning

confidence: 99%

Axillary ultrasound and fine-needle aspiration in preoperative staging of axillary lymph nodes in patients with invasive breast cancer

et al. 2015

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“…However, axillary US is operator-dependent and machine-dependent. When only US is used to assess ALNs, the sensitivity and specificity vary greatly ( 9 , 10 ). Therefore, in order to solve this problem, US-guided fine needle aspiration biopsy (FNAB) is required.…”

Section: Introductionmentioning

confidence: 99%

Axillary ultrasound and fine needle aspiration biopsy in the preoperative diagnosis of axillary metastases in early‑stage breast cancer

Zhou

Yang

et al. 2018

Oncol Lett

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The efficacy of axillary lymph node dissection (ALND) following sentinel lymph node biopsy (SLNB) has been questioned. The present study was performed to determine the sensitivity, specificity and accuracy of axillary ultrasound (US) and fine needle aspiration biopsy (FNAB) in the diagnosis of axillary metastases in patients with early breast cancer. A total of 214 patients with stage I and II breast cancer between June 2015 and January 2017 were included. All of the patients received axillary US as a primary investigation for lymph node status. US-guided FNAB was performed on suspicious lymph nodes. Those with non-suspicious and FNAB-negative axillary nodes proceeded to SLNB at the time of primary breast surgery. ALND was performed when the result of the US-guided FNAB was positive. The results of US and cytology were compared to histopathological results to determine their sensitivity, specificity, positive and negative predictive value and accuracy. A total of 76 out of 214 patients (35.5%) had axillary lymph node metastases at final histology. The sensitivity and specificity of axillary US alone were 59.2% (45/76) and 78.3% (108/138), respectively. Axillary US with FNAB identified 32 patients with positive lymph node metastases, and increased the sensitivity and specificity to 71.1% (32/45) and 100.0% (30/30). Combined with FNAB, the positive and negative predictive values were 100.0% (32/32) and 69.8% (30/43), respectively. Axillary US-alone or combined US/FNAB had a high accuracy rate and a satisfactory result as they cost less and it is easy to assess the status of axillary lymph nodes. Thus, axillary US with FNAB may avoid unnecessary SLNB in a significant number of patients.

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Assessing Whether Morphological Changes in Axillary Lymph Node Have Already Occurred Prior to Metastasis in Breast Cancer Patients by Ultrasound

et al. 2022

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Background and Objectives: Whether the morphological changes in axillary lymph node (ALN) have occurred prior to metastasis remains unclear in breast cancer (BC) patients. The aim of this study is to investigate the influence of BC for the morphology of non-metastasis ALN (N−) and, further, to improve the performance of ultrasound (US) examination for metastasis ALN (N+). Materials and Methods: In this retrospective study, 653 patients with breast mass were enrolled and divided into normal group of 202 patients with benign breast tumor, N− group of 233 BC patients with negative ALN and N+ group of 218 BC patients with positive ALN. US features of ALN were evaluated and analyzed according to long (L) and short (S) diameter, the (L/S) axis ratio, cortical thickness, lymph node edge, replaced hilum and color Doppler flow imaging (CDFI). Results: ALN US features of short diameter, replaced hilum, cortical thickness and CDFI have significant statistical differences in N− group comparing with normal group and N+ group, respectively (p < 0.05). Conclusions: Therefore, BC can affect ALN and lead to US morphological changes whether lymph node metastasis is present, which reduces the sensitivity of axillary US. The combination of US and other examination methods should be applied to improve the diagnostic performance of N+.

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Punção aspirativa de linfonodo axilar guiada pela ultrassonografia é eficaz como método de predição de acometimento linfonodal em pacientes com câncer de mama?

Cited by 4 publications

References 27 publications

Axillary ultrasound and fine-needle aspiration in preoperative staging of axillary lymph nodes in patients with invasive breast cancer

Axillary ultrasound and fine-needle aspiration in preoperative staging of axillary lymph nodes in patients with invasive breast cancer

Axillary ultrasound and fine needle aspiration biopsy in the preoperative diagnosis of axillary metastases in early‑stage breast cancer

Assessing Whether Morphological Changes in Axillary Lymph Node Have Already Occurred Prior to Metastasis in Breast Cancer Patients by Ultrasound

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