Rao Roshni, Lilley Lisa, Andrews Valerie, Radford Lee, Ulissey Michael
Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Ann Surg Oncol. 2009 May;16(5):1170-5. doi: 10.1245/s10434-009-0421-9. Epub 2009 Mar 5.
We sought to determine whether percutaneous core needle biopsy (CNB) of suspicious axillary lymph nodes in patients with breast cancer offers improved diagnostic accuracy compared with fine-needle aspiration (FNA).
Records of 400 patients were reviewed to identify patients undergoing ultrasound-guided biopsy followed by surgical axillary evaluation (sentinel lymph node biopsy or axillary lymph node dissection). Patients underwent diagnosis and treatment at a single high-volume county hospital. Data collected included demographics, treatment, biopsy, and surgical pathology. Percutaneous biopsy results were compared with results of sentinel lymph node biopsy or axillary lymph node dissection.
Forty-seven patients met final study criteria. Twenty-two patients underwent FNA, and 25 underwent CNB. Sensitivity of FNA was 75% vs. 82% for CNB. Specificity for both was 100%. Additionally, a cost comparison of CNB versus FNA revealed CNB to be $404; FNA cost was $237.
The current data do not support the routine use of CNB over FNA for preoperative axillary staging in breast cancer patients with clinically negative axillas. Additionally, the substantial increase in cost without a marked improvement in sensitivity may favor the performance of FNA.
我们试图确定，对于乳腺癌患者，经皮芯针活检（CNB）可疑腋窝淋巴结是否比细针穿刺抽吸活检（FNA）具有更高的诊断准确性。
回顾400例患者的记录，以识别接受超声引导活检并随后进行腋窝手术评估（前哨淋巴结活检或腋窝淋巴结清扫）的患者。患者在一家大型县级医院接受诊断和治疗。收集的数据包括人口统计学、治疗、活检和手术病理。将经皮活检结果与前哨淋巴结活检或腋窝淋巴结清扫结果进行比较。
47例患者符合最终研究标准。22例患者接受了FNA，25例接受了CNB。FNA的敏感性为75%，而CNB为82%。两者的特异性均为100%。此外，CNB与FNA的成本比较显示，CNB为404美元；FNA成本为237美元。
目前的数据不支持在腋窝临床阴性的乳腺癌患者术前腋窝分期中常规使用CNB而非FNA。此外，成本大幅增加而敏感性无明显改善可能更倾向于进行FNA。
