US-guided Core Needle Biopsy of Axillary Lymph Nodes in Patients with Breast Cancer: Why and How to Do It

Abé, Hiroyuki; Schmidt, Robert A.; Sennett, Charlene A.; Shimauchi, Akiko; Newstead, Gillian M.

doi:10.1148/rg.27si075502

Cited by 87 publications

(71 citation statements)

References 20 publications

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“…Ultrasound features for suspected axillary lymph nodes include asymmetric cortical thickening or lobulations, loss of fatty hilum, abnormal shape (rounded appearance), and increased peripheral flow (89). Ultrasound-guided needle biopsy is simple, relatively easy, minimally invasive, and safe (89).…”

Section: Figurementioning

confidence: 99%

The Role of Radiotracer Imaging in the Diagnosis and Management of Patients with Breast Cancer: Part 1—Overview, Detection, and Staging

Lee¹,

Rosen²,

Mankoff³

2009

J Nucl Med

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Breast cancer is the most common non-skin type of cancer and the second leading cause of cancer mortality in women. Advances in diagnosis and treatment have led to declines in mortality, despite an increase in breast cancer incidence. An advancing array of both local and systemic therapy options has led to increasingly individualized treatment. Imaging plays a key role in detecting breast cancer and directing its therapy. This continuing education article, part 1 in a 2-part series, provides a comprehensive review of current and future radiotracer imaging methods applied to breast cancer, in the context of breast cancer management strategies and other nonnuclear imaging methods. Part 1 of the review provides an overview of clinical and biologic considerations in breast cancer and covers radionuclide imaging for detection and staging. Part 2 will cover radionuclide imaging of breast cancer response to therapy, other clinical indications for radionuclide breast cancer imaging, and future directions, including molecular imaging.

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Section: Figurementioning

confidence: 99%

The Role of Radiotracer Imaging in the Diagnosis and Management of Patients with Breast Cancer: Part 1—Overview, Detection, and Staging

Lee¹,

Rosen²,

Mankoff³

2009

J Nucl Med

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“…In the very few studies that used CNB, the sensitivity and specificity were comparable to those of FNA biopsy. [26][27][28] US-guided FNA of the lymph nodes is generally performed by the radiologist using a 22-gauge or 23-gauge hypodermic needle with a 10-mL syringe attached to the needle, with or without the instillation of local anesthetic in and around the lymph node of interest. There are no recommendations for optimal processing of the aspirate.…”

mentioning

confidence: 99%

Current applications and future prospects of fine‐needle aspiration biopsy of locoregional lymph nodes in the management of breast cancer

Krishnamurthy

2009

Cancer Cytopathology

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Staging of disease is routine in the evaluation of patients newly diagnosed with breast cancer. Assessment of palpable and/or nonpalpable locoregional lymph nodes is an important component of the initial staging.Ultrasound (US) is the favored imaging modality for the initial investigation of lymph nodes and results in a significant increase in the specificity of the overall evaluation when used in conjunction with fine-needle aspiration (FNA). This review provides a concise summary, based on published literature, of the current applications and future prospects of FNA biopsy of locoregional lymph nodes in the initial staging and subsequent surgical management of patients with breast cancer. Patients undergo either sentinel lymph node (SLN) biopsy or complete axillary lymph node dissection, based on whether the axillary lymph node status is determined to be negative or positive in the initial staging process. The status of lymph nodes in the supraclavicular, infraclavicular, and internal mammary regions provides more accurate staging information and also impacts subsequent surgical management. The identification and evaluation of intramammary lymph nodes can add value in the overall assessment of patients with breast cancer. The feasibility of noninvasive imaging modalities for SLN mapping in animal models has indicated a good potential for FNA biopsy in the subsequent investigation of SLNs identified noninvasively in humans. Staging of the malignant tumor is a routine component in the assessment of patients who are newly diagnosed with breast cancer. Breast cancer staging aids in the appropriate management of patients at each stage of disease and is useful in estimating the prognosis for a patient at a particular stage. The routine staging process includes taking a thorough history of the patient, physical examination, mammography, ultrasonography (US) of the breast and lymph node basins, computed tomography (CT) scan of the abdomen, bone scanning, and chest radiography. Cancer is assigned a clinical stage at the time of the initial diagnosis based on the findings of the physical examination, radiologic studies, and core needle biopsy (CNB) of the

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“…In fact, Takashima et al [3] presents data that suggests that ultrasound is superior to CT and MRI. Complication rates for CT-guided punctures are reported in the range of 0.05% -2.5% [13], which is comparable to complication rates reported for sonographically guided punctures (0% -2.9%) [1][2][3][4][5][6][7][8][9][10]. A comparison study reported by Sheafor et al [14] also found no significant difference in the rate of complications between CT-and sonographically guided punctures.…”

Section: Discussionmentioning

confidence: 75%

“…No complications were recorded in the present patient collective. In the literature, reported rates are low, ranging from 0 to 2.9% [1][2][3][4][5][6][7][8][9][10] ( Table 1). Major complications were reported in two publications, both secondary to vascular injuries [3,6].…”

Section: Discussionmentioning

confidence: 99%

Sonographically guided lymph node biopsy: Complication rates

Mueller¹,

Wittich²,

Oeztuerk³

et al. 2012

OJCD

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Purpose: The study investigated the rate of complications associated with sonographically guided lymph node biopsies and assessed potential risk factors. Methods: A total of 536 sonographically guided puncture procedures (283 males, 52.8%; 253 females, 47.2%; average age 57.0 ± 16.0 years; range 14 -87 years) were performed in 469 patients for the work-up of unclear lymphadenopathy. Events, complications and potential risk factors, were prospectively documented. Results: The 469 patients underwent a total of 536 puncture procedures (PP) including 663 punctures and 1485 passes. Lymph node localizations were intraabdominal (55.2%, n = 296), cervical (22.4%, n = 120), inguinal (12.9%, n = 69), axillary (7.8%, n = 42) and other (1.7%, n = 9). No complications were documented during the entire study period. There was no increased risk of complications documented for the potential risk factors number of punctures, the number of passes, the localization, diameter of the lymph node (s), puncture technique, needle gauge, as well as patients' sex, age and coagulation parameters, and the experience of the examiner. Conclusions: Our findings confirm the safety of percutaneous sonographically guided lymph node biopsies in different regions of the body in patients with adequate coagulation parameters undergoing pre-interventional color Doppler ultrasound examination.

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US-guided Core Needle Biopsy of Axillary Lymph Nodes in Patients with Breast Cancer: Why and How to Do It

Cited by 87 publications

References 20 publications

The Role of Radiotracer Imaging in the Diagnosis and Management of Patients with Breast Cancer: Part 1—Overview, Detection, and Staging

The Role of Radiotracer Imaging in the Diagnosis and Management of Patients with Breast Cancer: Part 1—Overview, Detection, and Staging

Current applications and future prospects of fine‐needle aspiration biopsy of locoregional lymph nodes in the management of breast cancer

Sonographically guided lymph node biopsy: Complication rates

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