Evaluation of the combined role of axillary ultrasound with fine-needle aspiration cytology and sentinel lymph node biopsy in detecting axillary metastasis in clinically N0 axilla at tertiary care center Kerala

Background: Sentinel lymph node biopsy (SLNB) is the gold standard for histopathological staging of early breast cancer. Combination of axillary ultrasound with fine-needle aspiration cytology (Ax US with FNAC) of suspicious lymph nodes, specificity for diagnosis of metastatic lymph nodes can be increased.Methods: This prospective study was done among 205 cases with clinically N0 axilla visited at surgical oncology department at Amrita institute of medical sciences from January 2014 to February 2017. Exclusion criteria was patients with locally advanced breast cancer, previous axillary surgery, prior breast irradiation, proven distant metastasis, inflammatory breast cancer and neo-adjuvant chemotherapy. All patients were subjected to ultrasound of breast and axilla during preoperative evaluation. Suspicious looking nodes were subjected to image guided FNAC. Benign appearing nodes or a negative FNAC, a SLNB procedure with intra-operative frozen section sentinel node (FS SN) was performed at the time of surgery.Results: Present study found sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of Ax US was 62.9%, 84.4%, 67.7%, 81.4% and 77.1% respectively. Sensitivity, specificity, PPV, NPV and accuracy of Ax US with FNAC was 90.0%, 100.0%, 100.0%, 83.3% and 93.3% respectively. Sensitivity, specificity, PPV, NPV and accuracy of SLNB with FS SN was 64.5%, 97.5%, 87.0%, 91.5% and 90.8% respectively.Conclusions: US guided fine-needle aspiration biopsy (FNAB) has highest specificity and sensitivity. Combining Ax US±FNAC and intra-operative FS SN in the detecting axillary metastasis very much decrease the chance of false results. The results of sonography would allow patients with sonographically positive axillae to be directed to axillary lymph node dissection (ALND). The remaining patients would be candidates for SN biopsy.

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Role of fine needle aspiration cytology (FNAC) in head and neck neoplasms with histopathological correlation

National Journal of Clinical Anatomy ◽

10.1055/s-0039-3401554 ◽

2015 ◽

Vol 04 (02) ◽

pp. 80-85

Author(s):

Junu Devi ◽

Kunja Lal Talukdar

Keyword(s):

Lymph Node ◽

Head And Neck ◽

Fine Needle Aspiration ◽

Head And Neck Neoplasms ◽

Fine Needle Aspiration Cytology ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Fine Needle ◽

Needle Aspiration Cytology ◽

Sensitivity Specificity

Abstract Background : Fine needle aspiration cytology is a simple, quick,inexpensive and minimally invasive technique used to diagnose head and neck neoplasms commonly originated from cervical lymph node, thyroid, parotid and other salivary glands. In this study a correlation was done between cytology and histopathology whenever surgical specimens were available. Aim : To assess the frequency of various benign and malignant neoplasms in different age groups and to evaluate the sensitivity, specificity of fine needle aspiration cytology(FNAC) in head and neck neoplasms. Materials and method : The study was conducted between September 2011 to August 2013 and total 249 cases of head and neck neoplasms were analysed. Patients between 1 to 80 years were included in the study. Fine needle aspiration cytology (FNAC) diagnosis was correlated with histopathology whenever possible. Results: Out of 249 head and neck neoplasms 55.42% were from lymph node, 19.28% were from salivary gland, 14.86% were from thyroid gland, 1.20% were nasal mass, 9.24% from other sites (skin and soft tissue). M:F was 1.4:1. Most commonly affected age group was 51-60 years. Metastatic squamous cell carcinoma was most commonly encountered neoplastic lesion. Overall sensitivity, specificity oflme needle aspiration cytology(FNAC) were 97.92% and 91.67% respectively. Conclusion : Fine needle aspiration cytology is a highly sensitive, specific and has a definite role in diagnosing most of the head and neck neoplasms.

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Axillary ultrasound and fine-needle aspiration cytology to predict clinically relevant nodal burden in breast cancer patients

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02391-3 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Isabela Panzeri Carlotti Buzatto ◽

Francisco José Cândido dos Reis ◽

Jurandyr Moreira de Andrade ◽

Tamara Cristina Gomes Ferraz Rodrigues ◽

Jéssica Maria Camargo Borba ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Fine Needle Aspiration ◽

Axillary Lymph Node ◽

Needle Aspiration ◽

Axillary Lymph ◽

Axillary Ultrasound ◽

Aspiration Cytology ◽

Fine Needle ◽

Needle Aspiration Cytology

Abstract Background Axillary lymph node involvement is one important prognostic factor in breast cancer, but the way to access this information has been modified over the years. This study evaluated if axillary ultrasound (US) coupled with fine-needle aspiration cytology (FNAC) can accurately predict clinically relevant node metastasis in patients with breast cancer, and thus assist clinical decisions Methods This is a cross-sectional study with retrospective data collection of 241 individuals (239 women and 2 men) with unilateral operable breast cancer who were submitted to preoperative axillary assessment by physical exam, US and FNAC if suspicious nodes by imaging. We calculated sensitivity, specificity, and accuracy of the methods. We compared the patient's characteristics using chi-square test, parametrics and non-parametrics statistics according to the variable. Results The most sensible method was US (0.59; 95% CI, 0.50–0.69), and the most specific was US coupled with FNAC (0.97; 95% CI, 0.92–0.99). Only 2.7% of the patients with normal axillary US had more than 2 metastatic nodes in the axillary lymph node dissection, against 50% of the patients with suspicious lymph nodes in the US and positive FNAC. Conclusions Axillary US coupled with FNAC can sort patients who have a few metastatic nodes at most from those with heavy axillary burden and could be one more tool to initially evaluate patients and define treatment strategies.

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Ultrasonography and Fine-Needle Aspiration Cytology Can Spare Breast Cancer Patients Unnecessary Sentinel Lymph Node Biopsy

Annals of Surgical Oncology ◽

10.1245/aso.2005.01.024 ◽

2006 ◽

Vol 13 (1) ◽

pp. 31-35 ◽

Cited By ~ 133

Author(s):

Maartje C. van Rijk ◽

Eline E. Deurloo ◽

Omgo E. Nieweg ◽

Kenneth G. A. Gilhuijs ◽

Johannes L. Peterse ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Needle Aspiration ◽

Lymph Node Biopsy ◽

Breast Cancer Patients ◽

Aspiration Cytology ◽

Fine Needle ◽

Node Biopsy ◽

Needle Aspiration Cytology

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Efficacy of fine needle aspiration cytology as a primary diagnostic tool for cervical lymphadenopathy

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20212221 ◽

2021 ◽

Vol 9 (6) ◽

pp. 1552

Author(s):

Sarder M. Abu Horaira

Keyword(s):

Lymph Node ◽

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

Cervical Lymph Node ◽

Cervical Lymphadenopathy ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Fine Needle ◽

Needle Aspiration Cytology ◽

Sensitivity Specificity

Background: Cervical lymphadenopathy is a frequently encountered neck lesion in routine daily practice all over the globe. The etiology varies from a benign inflammatory process to a malignant condition. Fine needle aspiration cytology (FNAC) is now a days the initial investigation in most of the cases of cervical lymph node enlargement. The aim of this work was to evaluate the efficacy and diagnostic accuracy of fine needle aspiration cytology of cervical lymph nodes with an emphasis on discordant cases between the cytology and the histopathology.Methods: The present study was a retrospective one, conducted at the department of pathology, Rajshahi medical college and hospital located in west-northern region of Bangladesh over a period of one year (January 2019 to December 2019). FNAC assessed and histopathologically correlated 122 documented cases were included in the study.Results: The cytological diagnoses were detected to be benign in 107 cases (87.70%) and malignant in 15 cases (12.30%). Reactive lymphadenitis (67.20%) was the most common benign lesion followed by granulomatous lymphadenitis (16.40%). The overall diagnostic sensitivity, specificity, positive predictive value and negative predictive value of cytological diagnosis of cervical lymph node were 97.16%, 75%, 96.26% and 80%, respectively. The overall diagnostic accuracy was 94.26% while the overall discordance rate was 5.73%.Conclusions: FNAC is the preliminary investigation of choice in the diagnostic approach to most of the cases of cervical lymphadenopathy and it has good diagnostic sensitivity, specificity and accuracy.

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