THE COMBINATION OF AXILLARY ULTRASOUND AND ULTRASOUND-GUIDED BIOPSY IS AN ACCURATE PREDICTOR OF AXILLARY STAGE IN CLINICALLY NODE-NEGATIVE BREAST CANCER PATIENTS
Identifieur interne : 006919 ( Main/Exploration ); précédent : 006918; suivant : 006920THE COMBINATION OF AXILLARY ULTRASOUND AND ULTRASOUND-GUIDED BIOPSY IS AN ACCURATE PREDICTOR OF AXILLARY STAGE IN CLINICALLY NODE-NEGATIVE BREAST CANCER PATIENTS
Auteurs : Dana M. Holwitt [États-Unis] ; Mary Ellen Swatske [États-Unis] ; William E. Gillanders [États-Unis] ; Barbara S. Monsees [États-Unis] ; Feng Gao [États-Unis] ; Rebecca L. Aft [États-Unis] ; Timothy J. Eberlein [États-Unis] ; Julie A. Margenthaler [États-Unis]Source :
- American journal of surgery [ 0002-9610 ] ; 2008.
Abstract
The study aim was to determine the accuracy of axillary ultrasound (AUS) and fine needle aspiration biopsy (FNAB)/needle core biopsy in axillary breast cancer staging.
We reviewed 256 patients with clinically node-negative breast cancer who underwent AUS +/− FNAB/needle core biopsy. AUS-guided FNAB/needle core biopsy was compared to histopathology to determine sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV).
AUS-guided FNAB/needle core biopsy and final pathology were positive in 72/256 patients (28%). In 125/256 cases (49%), the AUS and final pathology were negative. Two of 110 patients had a false positive FNAB (1.8%); both received neoadjuvant chemotherapy. Nine patients (8%) had a false negative FNAB/needle core biopsy; the median size of lymph node metastasis was 3 mm. The sensitivity and specificity of AUS-guided FNAB/needle core biopsy was 71% and 99%, with a NPV of 84% and PPV of 97%.
AUS-guided FNAB/needle core biopsy is accurate in predicting the status of the axilla in 70% of clinically node-negative breast cancer patients. This technique is minimally invasive with a low complication rate and can obviate the need for staged lymph node procedures.
Url:
DOI: 10.1016/j.amjsurg.2008.06.006
PubMed: 18723153
PubMed Central: 3892698
Affiliations:
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Holwitt</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgery, Washington University School of Medicine, St. Louis, MO</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Missouri (État)</region></placeName><wicri:cityArea>Department of Surgery, Washington University School of Medicine, St. Louis</wicri:cityArea></affiliation></author><author><name sortKey="Swatske, Mary Ellen" sort="Swatske, Mary Ellen" uniqKey="Swatske M" first="Mary Ellen" last="Swatske">Mary Ellen Swatske</name><affiliation wicri:level="2"><nlm:aff id="A2">Department of Radiology, Washington University School of Medicine, St. Louis, MO</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Missouri (État)</region></placeName><wicri:cityArea>Department of Radiology, Washington University School of Medicine, St. Louis</wicri:cityArea></affiliation></author><author><name sortKey="Gillanders, William E" sort="Gillanders, William E" uniqKey="Gillanders W" first="William E." last="Gillanders">William E. Gillanders</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgery, Washington University School of Medicine, St. Louis, MO</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Missouri (État)</region></placeName><wicri:cityArea>Department of Surgery, Washington University School of Medicine, St. Louis</wicri:cityArea></affiliation></author><author><name sortKey="Monsees, Barbara S" sort="Monsees, Barbara S" uniqKey="Monsees B" first="Barbara S." last="Monsees">Barbara S. Monsees</name><affiliation wicri:level="2"><nlm:aff id="A2">Department of Radiology, Washington University School of Medicine, St. Louis, MO</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Missouri (État)</region></placeName><wicri:cityArea>Department of Radiology, Washington University School of Medicine, St. Louis</wicri:cityArea></affiliation></author><author><name sortKey="Gao, Feng" sort="Gao, Feng" uniqKey="Gao F" first="Feng" last="Gao">Feng Gao</name><affiliation wicri:level="2"><nlm:aff id="A3">Division of Biostatistics, Washington University School of Medicine, St. Louis, MO</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Missouri (État)</region></placeName><wicri:cityArea>Division of Biostatistics, Washington University School of Medicine, St. Louis</wicri:cityArea></affiliation></author><author><name sortKey="Aft, Rebecca L" sort="Aft, Rebecca L" uniqKey="Aft R" first="Rebecca L." last="Aft">Rebecca L. Aft</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgery, Washington University School of Medicine, St. Louis, MO</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Missouri (État)</region></placeName><wicri:cityArea>Department of Surgery, Washington University School of Medicine, St. Louis</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A4">Department of Surgery, John Cochran Veterans Hospital, St. Louis, MO</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Missouri (État)</region></placeName><wicri:cityArea>Department of Surgery, John Cochran Veterans Hospital, St. Louis</wicri:cityArea></affiliation></author><author><name sortKey="Eberlein, Timothy J" sort="Eberlein, Timothy J" uniqKey="Eberlein T" first="Timothy J." last="Eberlein">Timothy J. Eberlein</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgery, Washington University School of Medicine, St. Louis, MO</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Missouri (État)</region></placeName><wicri:cityArea>Department of Surgery, Washington University School of Medicine, St. Louis</wicri:cityArea></affiliation></author><author><name sortKey="Margenthaler, Julie A" sort="Margenthaler, Julie A" uniqKey="Margenthaler J" first="Julie A." last="Margenthaler">Julie A. Margenthaler</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgery, Washington University School of Medicine, St. Louis, MO</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Missouri (État)</region></placeName><wicri:cityArea>Department of Surgery, Washington University School of Medicine, St. Louis</wicri:cityArea></affiliation></author></analytic><series><title level="j">American journal of surgery</title><idno type="ISSN">0002-9610</idno><idno type="eISSN">1879-1883</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P1">The study aim was to determine the accuracy of axillary ultrasound (AUS) and fine needle aspiration biopsy (FNAB)/needle core biopsy in axillary breast cancer staging.</p></sec><sec id="S2"><title>Methods</title><p id="P2">We reviewed 256 patients with clinically node-negative breast cancer who underwent AUS +/− FNAB/needle core biopsy. AUS-guided FNAB/needle core biopsy was compared to histopathology to determine sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV).</p></sec><sec id="S3"><title>Results</title><p id="P3">AUS-guided FNAB/needle core biopsy and final pathology were positive in 72/256 patients (28%). In 125/256 cases (49%), the AUS and final pathology were negative. Two of 110 patients had a false positive FNAB (1.8%); both received neoadjuvant chemotherapy. Nine patients (8%) had a false negative FNAB/needle core biopsy; the median size of lymph node metastasis was 3 mm. The sensitivity and specificity of AUS-guided FNAB/needle core biopsy was 71% and 99%, with a NPV of 84% and PPV of 97%.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">AUS-guided FNAB/needle core biopsy is accurate in predicting the status of the axilla in 70% of clinically node-negative breast cancer patients. This technique is minimally invasive with a low complication rate and can obviate the need for staged lymph node procedures.</p></sec></div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Missouri (État)</li></region></list><tree><country name="États-Unis"><region name="Missouri (État)"><name sortKey="Holwitt, Dana M" sort="Holwitt, Dana M" uniqKey="Holwitt D" first="Dana M." last="Holwitt">Dana M. Holwitt</name></region><name sortKey="Aft, Rebecca L" sort="Aft, Rebecca L" uniqKey="Aft R" first="Rebecca L." last="Aft">Rebecca L. Aft</name><name sortKey="Aft, Rebecca L" sort="Aft, Rebecca L" uniqKey="Aft R" first="Rebecca L." last="Aft">Rebecca L. Aft</name><name sortKey="Eberlein, Timothy J" sort="Eberlein, Timothy J" uniqKey="Eberlein T" first="Timothy J." last="Eberlein">Timothy J. Eberlein</name><name sortKey="Gao, Feng" sort="Gao, Feng" uniqKey="Gao F" first="Feng" last="Gao">Feng Gao</name><name sortKey="Gillanders, William E" sort="Gillanders, William E" uniqKey="Gillanders W" first="William E." last="Gillanders">William E. Gillanders</name><name sortKey="Margenthaler, Julie A" sort="Margenthaler, Julie A" uniqKey="Margenthaler J" first="Julie A." last="Margenthaler">Julie A. Margenthaler</name><name sortKey="Monsees, Barbara S" sort="Monsees, Barbara S" uniqKey="Monsees B" first="Barbara S." last="Monsees">Barbara S. Monsees</name><name sortKey="Swatske, Mary Ellen" sort="Swatske, Mary Ellen" uniqKey="Swatske M" first="Mary Ellen" last="Swatske">Mary Ellen Swatske</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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