Evaluation of non-palpable axillary lymph nodes metastasis with ultrasonography guided fine needle aspiration cytology in carcinoma breast and comparing with histopathological report
DOI:
https://doi.org/10.18203/2349-2902.isj20213135Keywords:
Ultrasound guided FNAC, HPE, Axillary clearanceAbstract
Background: Breast malignancies are the second most common cause of cancer related mortality among women. As the size of the primary breast cancer increases, some cancer cells are shed into cellular spaces and transported via the lymphatic network of the breast to the regional lymph nodes, especially the axillary lymph nodes. Objective of the study is to evaluate the diagnostic accuracy of axillary ultrasound (US) guided fine-needle-aspiration cytology (FNAC) in patients with breast carcinoma, in comparison with the final histological examination (sentinel node biopsy and/or axillary dissection).
Methods: This prospective study will be conducted on 40 consecutive patients with biopsy proven breast cancer with clinically negative axilla, who had attending the OPD or IPD in our department of surgery, SGRD hospital Amritsar. All of these patients are planned to undergo surgery (breast conservation or modified radical mastectomy with axillary clearance).
Results: Patients detected with LN metastasis on FNAC can directly undergo axillary dissection without the need of any other diagnostic technique like SLNB in non-palpable axillary lymph nodes.
Conclusions: Thus, we can conclude that ultrasonography (USG) guided FNAC due to its moderate sensitivity, high specificity and PPV in relation to histopathological examination (HPE) is a good diagnostic technique for diagnosing patients with axillary lymph node metastasis in case of clinically non palpable axillary lymph nodes in carcinoma breast patients.
Metrics
References
Sumita AJ, Lakshman A, Ashish G, Ranjan K, Shravan, Atul A et al. Study on efficacy of preoperative ultrasonography for axillary lymph node involvement in breast carcinoma. IOSR J Dent Med Sci. 2014;13(4):1-5.
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-24.
Park K. Park's textbook of preventive and social medicine. 20th ed. Jabalpur: M/S BanarsidasBhanot. 2011.
Ferlay J, E. Globocan 2002: Cancer Incidence, Mortality and Prevalence Worldwide. Lyon, France: IARC Press. 2004.
Clarke CA, Glaser SL, Uratsu SL, Selby JV, Kushi LH, Herrington LJ. Recent declines in hormone therapy utilization and breast cancer incidence: clinical and population-based evidence. J ClinOncol. 2006;24:49–50.
17 Alkuwari E, Auger M. Accuracy of fine-needle aspiration cytology of axillary lymph nodes in breast cancer patients: a study of 115 cases with cytologic-histologic correlation. Cancer. 2008;114(2):89-93.
18 Holwitt DM, Swatske ME, Gillanders WE, Monsees BS, Gao F, Aft RL et al. The combination of axillary ultrasound and ultrasound-guided biopsy is an accurate predictor of axillary stage in clinically node-negative breast cancer patients, Am J Surg. 2008;196(4):477-82.
Akinci M, Cetin B, Aslan S, Kulacoglu H. Factors affecting seroma formation after mastectomy with full axillary dissection. ActaChir Belg. 2009;109:481–3.
Halsted W. Developments in the skin grafting operations for cancer of the breast. JAMA. 1913;60:416-51.
Belz GT, Heath TJ. Pathways of blood flow to and through superficial lymph nodes in the dog. J Anat. 1995;187:413–21.
Hay JB, Hobbs BB. The flow of blood to lymph nodes and its relation to lymphocyte traffic and the immune response. J Exp Med. 1977;145:31–44.
Feu J, Tresserra F, Fabregas R. Metastatic breast carcinoma in axillary lymph nodes: in vitro US detection. Radiol. 1997;205:831–5.
Jain SA, Agarwal L, Goyal A, Kumar R, Shravan, Ameta A, et al. Study on efficacy of preoperative ultrasonography for axillary lymph node involvement in breast carcinoma. IOSR J Dent Med Sci. 2014;13:1-5.
Sandoughdaran S, Malekzadeh M, Akbari M. Frequency and Predictors of Axillary Lymph Node Metastases in Iranian Women with Early Breast Cancer. Asian Pacific JCanPreven. 2018; 19(6):1617-20.
Kocic B, Filipovic S, Petrovic B, Mijalkovic D, Rancic N, Poultsidi A. Clinical and biological characteristics of breast cancer. J BUON. 2010;15(4):660-7.
Schiettecatte A, Bourgain C, Breucq C, Buls N, De Wilde V, de Mey J. Initial axillary staging of breast cancer using ultrasound-guided fine needle aspiration: a liquid-based cytology study. Cytopathol.2011;22(1):30–5.
Baruah BP, Goyal A, Young P, Douglas-Jones AG, Mansel RE. Axillary node staging by ultrasonography and fine-needle aspiration cytology in patients with breast cancer. Bri J Surg.2010;97(5):680–3.
Hayes BD, Feeley L, Quinn CM, Kennedy MM, O’Doherty A, Flanagan F et al. Axillary fine needle aspiration cytology for pre-operative staging of patients with screen-detected invasive breast carcinoma. J ClinPathol.2010;64(4):338–42.
Kramer GM, Leenders MW, Schijf LJ, Go HL, van der Ploeg T, van Den Tol MP et al. Is ultrasound-guided fine-needle aspiration cytology of adequate value in detecting breast cancer patients with three or more positive axillary lymph nodes?Breast Cancer Res Treat. 2016;156(2):271-8.
Sandoughdaran S, Malekzadeh M, Akbari M. Frequency and Predictors of Axillary Lymph Node Metastases in Iranian Women with Early Breast Cancer. Asian PacJCancer Prevent. 2018;19(6):1617-20.
