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.