Other Methods of Axillary Assessment and Their Value

Diagnostic Yield of Fine-Needle Aspiration for Axillary Lymph Nodes During Screening Breast Ultrasound

“…Many studies have shown that nodal size and US features such as LN echogenicity, border, shape, cortical morphology, and vascular flow are useful predictors for possible tumor invasion. 2,6,16,17 However, among these, the cutoff for positive interpretation of these US finding should be used when considering the PPV of each feature. Although the evaluation of PPV for abnormal US features was limited because ).…”

“…In our institution, axillary scanning is routinely included in all breast US, and the US features for abnormal findings of the LN are as follows: loss of fatty hilum, eccentric cortical thickening, round shape, extranodal extension, and marked hypoechoic cortex. 2,6 Lymph nodes with more than one of the abnormal US findings or a shortaxis size of more than 1 cm were regarded as "suspicious malignancy," and we performed US-FNA under the radiologist's judgment.…”

“…We also evaluated whether the LNs had abnormal US features as mentioned earlier and also calculated the PPV of each finding: loss of fatty hilum, eccentric cortical thickening, round shape, extranodal extension, and marked hypoechoic cortex. 2,6 Categorical data were summarized by frequencies and percentages. Lymph node size according to the long/short axis and cortical thickness was expressed in values of mean (SD) (in mm) and median size for those who had a negative and positive result for malignancy according to cytological results, respectively.…”

“…1 Information about axillary status is very useful in predicting prognosis in patients with breast cancers, and multiple studies have shown that with increasing tumor size, LNs more frequently harbor metastatic disease. 2 Ultrasound-guided fine-needle aspiration (US-FNA) is easily performed on LNs and can be used to select a certain patient management such as preoperative LN dissection or neoadjuvant chemotherapy. 2 Among patients without known malignancy, an axillary lump can be one sign of breast cancer, but it only accounts for 0.3% to 1% of all breast cancers in the published literature.…”

“…2 Ultrasound-guided fine-needle aspiration (US-FNA) is easily performed on LNs and can be used to select a certain patient management such as preoperative LN dissection or neoadjuvant chemotherapy. 2 Among patients without known malignancy, an axillary lump can be one sign of breast cancer, but it only accounts for 0.3% to 1% of all breast cancers in the published literature. 3,4 In our review of previous literatures, there are no reports of asymptomatic axillary metastasis from occult breast cancer or of malignancy yield rate with incidentally detected nonpalpable axillary LNs.…”