General Surgery Clinics of University of Health Sciences, Ankara Oncology Education and Research Hospital, Ankara, Turkey.
Radiology Clinics of University of Health Sciences, Ankara Oncology Education and Research Hospital, Ankara, Turkey.
Int J Clin Pract. 2021 Aug;75(8):e14332. doi: 10.1111/ijcp.14332. Epub 2021 May 17.
The aim of this study was to assess the efficacy of preoperative axillary ultrasonography (AUS) and preoperative axillary fine-needle aspiration biopsy (FNAB) from suspicious lymph nodes in clinically node-negative breast cancer to compare with radiologically positive and sentinel lymph node biopsy (SLNB) positive involvement.
Clinically node-negative early-stage breast cancer patients were included in the study. These patients underwent preoperative AUS examination, suspicious lymph nodes were evaluated with FNAB. AUS-FNAB results were compared with those of SLNB or axillary dissection.
Of 181 patients undergoing AUS, 32 were reported to have axillary metastasis, 25 suspicious, and 124 benign nodes. The suspicious group underwent FNAB examination and metastasis was found in 9 of them. The sensitivity of AUS-FNAB was found to be 64.06%, specificity 100%, positive predictive value 100%, and negative predictive value (NPV) 83.5%. The false negativity rate (FN) of this method was 16,4%. Lymphovascular invasion and tumour size were found statistically significant factors for false negativity.
It was concluded that axillary AUS-FNAB with its high NPV, low FN rate, may be a clinical alternative to SLNB for early-stage breast cancer patients.
本研究旨在评估术前腋窝超声（AUS）和术前可疑淋巴结的细针抽吸活检（FNAB）对临床淋巴结阴性乳腺癌的疗效，与放射学阳性和前哨淋巴结活检（SLNB）阳性浸润进行比较。
本研究纳入了临床淋巴结阴性的早期乳腺癌患者。这些患者接受了术前 AUS 检查，可疑淋巴结用 FNAB 进行评估。AUS-FNAB 结果与 SLNB 或腋窝清扫术进行比较。
在 181 例行 AUS 的患者中，有 32 例报告腋窝转移，25 例可疑，124 例良性淋巴结。可疑组进行了 FNAB 检查，其中 9 例发现转移。AUS-FNAB 的灵敏度为 64.06%，特异性为 100%，阳性预测值为 100%，阴性预测值（NPV）为 83.5%。该方法的假阴性率（FN）为 16.4%。淋巴血管侵犯和肿瘤大小是假阴性的统计学显著因素。
腋窝 AUS-FNAB 具有较高的 NPV 和较低的 FN 率，可能是早期乳腺癌患者替代 SLNB 的临床选择。
