scholarly journals DIAGNOSTIC VALUUE OF FINE NEEDLE ASPIRATION CYTOLOGY (FNAC) BIOPSY AND LYMPH NODES IN BREAST TUMOURS

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Surendra Kumar Dhruv
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Axillary Lymph Node ◽  
Needle Aspiration ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Ultrasound Guided ◽  
Aspiration Cytology ◽  
Needle Aspiration Cytology

INTRODUCTION:  Breast cancer is the most common solid cancer in women and one of the leading causes of cancer deaths in the western countries. In India it is a leading cause for mortality and morbidity. Prognosis of invasive ductal carcinoma (IDC) of breast is determined by anatomic extent of the disease and can be assessed by tumor size, lymph node status and metastasis, also biologic markers such as histological grade, hormone receptor expression, HER2 overexpression, and/or amplification and genomic panels can be used. The presence of metastatic in axillary lymph nodes confirms the capacity of a cancer to metastasize. It represents the single most prognostically potent element of clinical stage in potentially curable cases. Axillary lymph node dissection and histological evaluation has a continuing place in the staging and management of patients with breast cancer. It has been shown that cytological grade correlates well with the axillary lymph nodal metastasis and also prognosis. Axillary lymph node evaluation in breast cancer is usually performed preoperatively by clinical examination, sonography, lymph node resection and by ultrasound-guided fine-needle aspiration cytology. MATERIAL AND METHODS: Patients with detected breast mass (palpable and non-palpable) and palpable axillary lymph node who were evaluated by FNAC. After sterile draping and sufficient disinfection, a 10-ml syringe was inserted into and withdrawn from the lymph node three times under aspiration while sonographically monitored. The procedure was performed by using 21-22 Gauge needle with 2–4 aspirations and it was repeated if the sample was inadequate. Ultrasound guided FNAC was performed for impalpable, and deeply located small lumps. RESULTS: A total of 156 patients were underwent for FNAC of the breast lump. Histological correlation of all the patients was done. The mean age of patients who underwent FNAC was 39.6 ± 9.42 years and all were female patients. The cytology reports were classified as benign, atypical, suspicious, malignancy, and unsatisfactory. In 59 (37.8%) cases benign lesions were observed of which the fibrocystic disease was the most common cytological diagnosis. 15 (9.6%) were atypical, 7(4.5%) were suspicious and in 72(46.2%) cases malignancy was diagnosed. In 3 (1.9%) cases sample was unsatisfactory. FNAC of the axillary lymph nodes was performed on 76 patients with palpable lymph nodes and histological correlation of axillary lymph node. In FNAC and histology correlation of axillary lymph node sensitivity was 81.94% (95% CI 71.11% to 90.02%) and specificity was 100% (95% CI39.76% to 100.00%) with positive predictive value of 100%. CONCLUSION: FNAC is a rapid, cost effective and safe procedure for management of breast lumps.

scholarly journals Comparative study between ultrasound-guided fine needle aspiration cytology of axillary lymph nodes and sentinel lymph node histopathology in early-stage breast cancer

2017 ◽  
Vol 13 (5) ◽  
pp. 3299-3302 ◽  
Author(s):  
Lívio Portela Cardoso-Coelho ◽  
Rafael Soares Borges ◽  
Airlane Pereira Alencar ◽  
Larysse Maira Cardoso-Campos-Verdes ◽  
João Paulo da Silva-Sampaio ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Early Stage ◽  
Needle Aspiration ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Ultrasound Guided ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology

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

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.

scholarly journals Shortcomings of ultrasound-guided fine needle aspiration in the axillary management of women with breast cancer

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Michel Attieh ◽  
Faek Jamali ◽  
Ghina Berjawi ◽  
Mothana Saadeldine ◽  
Fouad Boulos
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Fine Needle Aspiration ◽  
Axillary Lymph Node ◽  
Needle Aspiration ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Ultrasound Guided ◽  
Fine Needle

Abstract Background Ultrasound, along with ultrasound-guided fine needle aspiration, is currently used for the axillary evaluation of breast cancer patients in order to identify candidates for axillary lymph node dissection. The aim of this study is to evaluate the accuracy of this tool in correctly identifying patients who may or may not benefit from axillary clearance in light of the ACOSOG Z0011 trial recommendations. Methods One hundred one patients (65 with positive US-FNA with corresponding axillary lymph node dissection (ALND), and 36 with negative US-FNA with corresponding ALND/sentinel lymph node biopsy) were studied for the number of involved axillary lymph nodes, tumor clinicopathologic features, and axillary radiologic findings. Results From the positive US-FNA group, 43% of patients had two or fewer positive lymph nodes upon ALND pathologic examination. In the US-FNA negative group, the negative predictive value for detecting axillary disease was 72.7%. With both groups combined, the sensitivity, specificity, PPV, and NPV of US-FNA for selecting patients based on axillary disease burden were 86%, 51.7%, 57%, and 83.3%, respectively. Conclusion Based on Z0011 guidelines, US-FNA is not a reliable tool in triaging patients in need for ALND and leads to overtreatment of 43% patients when positive, while depriving a small but significant percentage of patients from necessary therapy, when negative.

scholarly journals Dedicated Axillary MRI-Based Radiomics Analysis for the Prediction of Axillary Lymph Node Metastasis in Breast Cancer

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 757
Author(s):  
Sanaz Samiei ◽  
Renée W. Y. Granzier ◽  
Abdalla Ibrahim ◽  
Sergey Primakov ◽  
Marc B. I. Lobbes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Axillary Lymph Node ◽  
Axillary Lymph Node Metastasis ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Mr Images ◽  
Node Metastasis

Radiomics features may contribute to increased diagnostic performance of MRI in the prediction of axillary lymph node metastasis. The objective of the study was to predict preoperative axillary lymph node metastasis in breast cancer using clinical models and radiomics models based on T2-weighted (T2W) dedicated axillary MRI features with node-by-node analysis. From August 2012 until October 2014, all women who had undergone dedicated axillary 3.0T T2W MRI, followed by axillary surgery, were retrospectively identified, and available clinical data were collected. All axillary lymph nodes were manually delineated on the T2W MR images, and quantitative radiomics features were extracted from the delineated regions. Data were partitioned patient-wise to train 100 models using different splits for the training and validation cohorts to account for multiple lymph nodes per patient and class imbalance. Features were selected in the training cohorts using recursive feature elimination with repeated 5-fold cross-validation, followed by the development of random forest models. The performance of the models was assessed using the area under the curve (AUC). A total of 75 women (median age, 61 years; interquartile range, 51–68 years) with 511 axillary lymph nodes were included. On final pathology, 36 (7%) of the lymph nodes had metastasis. A total of 105 original radiomics features were extracted from the T2W MR images. Each cohort split resulted in a different number of lymph nodes in the training cohorts and a different set of selected features. Performance of the 100 clinical and radiomics models showed a wide range of AUC values between 0.41–0.74 and 0.48–0.89 in the training cohorts, respectively, and between 0.30–0.98 and 0.37–0.99 in the validation cohorts, respectively. With these results, it was not possible to obtain a final prediction model. Clinical characteristics and dedicated axillary MRI-based radiomics with node-by-node analysis did not contribute to the prediction of axillary lymph node metastasis in breast cancer based on data where variations in acquisition and reconstruction parameters were not addressed.

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