scholarly journals A Rapidly Enlarging Squamous Inclusion Cyst in an Axillary Lymph Node following Core Needle Biopsy

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Cunxian Zhang ◽  
Jinjun Xiong ◽  
M. Ruhul Quddus ◽  
Joyce J. Ou ◽  
Katrine Hansen ◽  
...  
Keyword(s):  
Lymph Node ◽  
Core Needle Biopsy ◽  
Axillary Lymph Node ◽  
Needle Biopsy ◽  
Axillary Lymph ◽  
Inclusion Cyst ◽  
Epithelioid Cells ◽  
Core Needle ◽  
Reactive Changes ◽  
Touch Preparation

A 73-year-old woman was found to have a 1.7 cm axillary mass, for which a core needle biopsy was performed. The specimen revealed fragmented squamous epithelium surrounded by lymphoid tissue consistent with a squamous inclusion cyst in a lymph node, but a metastatic squamous cell carcinoma could not be excluded. Within one month, the lesion enlarged to 5 cm and was excised. Touch preparation cytology during intraoperative consultation displayed numerous single and sheets of atypical epithelioid cells with enlarged nuclei and occasional mitoses, suggesting a carcinoma. However, multinucleated giant cells and neutrophils in the background indicated reactive changes. We interpreted the touch preparation as atypical and recommended conservative surgical management. Permanent sections revealed a ruptured squamous inclusion cyst in a lymph node with extensive reactive changes. Retrospectively, the atypical epithelioid cells on touch preparation corresponded to reactive histiocytes. This is the first case report of a rapidly enlarging ruptured squamous inclusion cyst in an axillary lymph node following core needle biopsy. Our case demonstrates the diagnostic challenges related to a ruptured squamous inclusion cyst and serves to inform the readers to consider this lesion in the differential diagnosis for similar situations.

Accuracy of Preoperative Ultrasound-Guided Axillary Lymph Node Core Needle Biopsy to Predict Axillary Lymph Node Involvement in Breast Cancer

2021 ◽  
Vol 104 (6) ◽  
pp. 964-968
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Core Needle Biopsy ◽  
Axillary Lymph Node ◽  
Needle Biopsy ◽  
Breast Cancer Surgery ◽  
Axillary Lymph ◽  
Ultrasound Guided ◽  
Core Needle ◽  
Preoperative Ultrasound

Background: Breast cancer operative management consists of breast surgery and axillary lymph node (ALN) assessment. ALN status is an important prognostic factor and determinant of breast cancer treatment. Objective: To investigate preoperative ultrasound-guided axillary lymph node core needle biopsy (USACNB) accuracy in predicting ALN involvement for breast cancer. Materials and Methods: This retrospective cohort study took place between February 2014 and May 2019. One hundred nine consecutive operable breast cancer patients with suspicious ALN involvement were assessed using preoperative USACNB and subsequent breast cancer surgery. Exclusion criteria were insufficient ALN tissue from USACNB for interpretation, previous breast or axillary surgery on the same side. Patients with preoperative histopathology results proving of metastasis underwent ALN dissection (ALND) while those with negative results had sentinel lymph node biopsy (SLNB). When SLNB was positive, ALND was then performed. Preoperative USACNB accuracy was analyzed using SLNB or ALND pathological results as standard tests. Results: The sensitivity, specificity, PPV, and NPV of preoperative USACNB in evaluating ALN involvement was 87.5%, 100%, 100%, and 80.4%, respectively, with an accuracy of 91.7%. Conclusion: Preoperative USACNB shows high diagnostic accuracy in ALN metastasis, but its NPV remains too low to completely rule out ALN involvement. Standard SLNB is still necessary in cases of negative USACNB. Keywords: Breast cancer; Ultrasound guided core needle biopsy; Axillary lymph node

Risk of invasion and axillary lymph node metastasis in ductal carcinomain situ diagnosed by core-needle biopsy

2007 ◽  
Vol 94 (8) ◽  
pp. 952-956 ◽  
Author(s):  
P. Meijnen ◽  
H. S. A. Oldenburg ◽  
C. E. Loo ◽  
O. E. Nieweg ◽  
J. L. Peterse ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Axillary Lymph Node Metastasis ◽  
Axillary Lymph ◽  
Ductal Carcinomain Situ ◽  
Core Needle ◽  
Node Metastasis ◽  
Carcinomain Situ

scholarly journals Diagnosis of Intracystic Papillary Carcinoma of the Breast by Preoperative Core Needle Biopsy: A Case Report

2017 ◽  
Vol 102 (3-4) ◽  
pp. 119-124 ◽  
Author(s):  
Keiichi Takahashi
Keyword(s):  
Lymph Node ◽  
Papillary Carcinoma ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Preoperative Diagnosis ◽  
Preoperative Imaging ◽  
Axillary Lymph ◽  
Core Needle ◽  
Intracystic Papillary Carcinoma ◽  
Solid Part

Intracystic papillary carcinoma (ICPC) of the breast is rare. It is categorized as noninfiltrating papillary ductal carcinoma in situ (DCIS). It protrudes and grows into the inner cavity in a papillary form, usually unaccompanied by severe infiltration in the surrounding interstitium. ICPC is often a noninfiltrating carcinoma and differentiating it from benign intracystic papilloma is difficult using preoperative imaging alone. Therefore, deciding on a treatment policy is often difficult. For correct diagnosis, it is vital to perform fine needle aspiration (FNA) or core needle biopsy (CNB) of the intracystic solid part accurately and under ultrasound guidance. However, the rate of accurate diagnosis by FNA cytology is low, and diagnosis by CNB is reported to be more effective than cytology. CNB of the solid part of a cyst for preoperative diagnosis is difficult and has a sensitivity of 60%. There is also a report stating that preoperative diagnosis could not be obtained in 40% of patients with ICPC. Therefore, biopsy by resection should be considered in patients who cannot be diagnosed by either FNA or CNB. However, DCIS had better be preoperatively diagnosed because not only axillary lymph node dissection but also sentinel lymph node biopsy might be omitted. The patient was a 42-year-old woman. She found a tumor mass in the left inner breast 10 weeks before her initial visit to the author's clinic. It was difficult to differentiate between the benignity or malignancy of the tumor from images, but a diagnosis of ICPC was made using preoperative CNB.

scholarly journals Necessity of sentinel lymph node biopsy in ductal carcinoma in situ patients: a retrospective analysis

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Young Duck Shin ◽  
Hyung-Min Lee ◽  
Young Jin Choi
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Node Metastasis ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Ductal Carcinoma ◽  
Invasive Cancer ◽  
Total Mastectomy ◽  
Core Needle ◽  
Node Metastasis

Abstract Background Sentinel lymph node biopsy (SLNB) is unnecessarily performed too often, owing to the high upstaging rates of ductal carcinoma in situ (DCIS). This study aimed to evaluate the upstaging rates of DCIS to invasive cancer, determine the prevalence of axillary lymph node metastasis, and identify the clinicopathological factors associated with upstaging and lymph node metastasis. We also examined surgical patterns among DCIS patients and determined whether SLNB guidelines were followed. Methods We retrospectively analysed 307 consecutive DCIS patients diagnosed by preoperative biopsy in a single centre between 2014 and 2018. Data from clinical records, including imaging studies, axillary and breast surgery types, and pathology results from preoperative and postoperative biopsies, were extracted. Univariate analyses using Chi-square tests and multiple logistic regression analyses were used to analyse the data. Results The rate of upstaging to invasive cancer was 19.2% (59/307). DCIS diagnosed by core-needle biopsy (odds ratio [OR]: 6.861, 95% confidence interval [CI]: 2.429–19.379), the presence of ultrasonic mass-forming lesions (OR: 2.782, 95% CI: 1.224–6.320), and progesterone receptor-negative status (OR: 3.156, 95% CI: 1.197–8.323) were found to be associated with upstaging. The rate of sentinel lymph node metastasis was only 1.9% (4/202), and all were total mastectomy patients diagnosed by core-needle biopsy. SLNB was performed in 37.2% of 145 breast-conserving surgery patients and 91.4% of 162 total mastectomy patients. Among the 202 patients who underwent SLNB, 145 (71.7%) without invasive cancer on final pathology had redundant SLNB. Two of 59 patients (3.4%) with disease upstaged to invasive cancer had inadequate primary staging of the axilla, as the rate seemed sufficiently small. Conclusions In patients with a preoperative diagnosis of DCIS, although an unavoidable possibility of upstaging to invasive cancer exists, axillary metastasis is unlikely. Only 2.7% of patients with DCIS undergoing total mastectomy were found to have sentinel lymph node metastases. SLNB should not be performed in breast-conserving surgery patients and should be reserved only for total mastectomy patients diagnosed by core-needle biopsy.

scholarly journals Feasibility of preoperative tattooing of percutaneously biopsied axillary lymph node: an experimental pilot study

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Abida K. Sattar ◽  
Basim Ali ◽  
Imrana Masroor ◽  
Shaista Afzal ◽  
Mohammad Usman Tariq ◽  
...  
Keyword(s):  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Axillary Lymph Node ◽  
Needle Biopsy ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Node Negative ◽  
Node Biopsy ◽  
India Ink ◽  
Clinically Node Positive

Abstract Background In the last three decades, axillary lymph node dissection (ALND) has been replaced by sentinel lymph node biopsy (SLNB) in all clinically node-negative patients. However, when SLNB alone is performed in clinically node-positive patients who are rendered node-negative by neoadjuvant chemotherapy, the procedure has a high false-negative rate and other complementary procedures have been described to improve its reliability. Preoperative tattooing of the suspicious lymph node with India ink at the time of biopsy, in addition to sentinel lymph node biopsy, is a reasonable alternative. The objective of our study is to determine, in clinically node-positive patients, the feasibility of tattooing suspicious axillary lymph node at the time of percutaneous needle biopsy and its retrieval at the time of surgery. Methods A prospective experimental study will be conducted divided into two phases—phases I and II. In phase I, 10 patients committed to undergo upfront surgery (without neoadjuvant chemotherapy) will have a suspicious lymph node tattooed by injecting India ink at the time of core needle biopsy. All patients will undergo a SLNB, during which the axilla will be inspected to determine if the tattooed lymph node can be visualized. Routine microscopic examination will follow, and concordance between the sentinel and tattooed node will also be established. In phase II, the process will be repeated for 30 patients who undergo surgery after neoadjuvant chemotherapy. The analysis will be performed in Stata version 12. Discussion There is a need to identify and test the techniques for the down-staged axilla in post-neoadjuvant chemotherapy patients, which are not only practical and limit the number of invasive procedures necessary but are representative of the new axillary status and help limit the extent of axillary surgery without negatively impacting outcomes. We propose that, for the patient undergoing neoadjuvant chemotherapy with a biopsy-proven disease in the axilla, this could be achieved by India ink which allows marking, identification, and retrieval of the biopsied lymph node. Retrieval of this previously biopsied lymph node along with sentinel nodes, if found to be representative of the status of the remainder of the axilla, could potentially eliminate the need for routine axillary lymph node dissection and thus limit morbidity. Trial Registration ClinicalTrials.gov, NCT03939598. Retrospectively registered on 7 May 2019.

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

Radiographics ◽  
2007 ◽  
Vol 27 (suppl_1) ◽  
pp. S91-S99 ◽  
Author(s):  
Hiroyuki Abe ◽  
Robert A. Schmidt ◽  
Charlene A. Sennett ◽  
Akiko Shimauchi ◽  
Gillian M. Newstead
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Core Needle

Preoperative staging of axillary lymph nodes in breast cancer: Ultrasonographic parameters and ultrasound-guided core needle biopsy

2011 ◽  
Vol 53 (6) ◽  
pp. 544-551
Author(s):  
M.Y. Torres Sousa ◽  
M.E. Banegas Illescas ◽  
M.L. Rozas Rodríguez ◽  
M. Arias Ortega ◽  
L.M. González López ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Preoperative Staging ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Ultrasound Guided ◽  
Core Needle
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