Axillary lymph node echo-guided fine-needle aspiration cytology enables breast cancer patients to avoid a sentinel lymph node biopsy. Preliminary experience and a review of the literature
Axillary lymph node echo-guided fine-needle aspiration cytology enables breast cancer patients to avoid a sentinel lymph node biopsy. Preliminary experience and a review of the literature
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DOI：
10.1007/s00595-006-3366-7
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发表时间：
2007-09-01
期刊：
影响因子：
2.5
通讯作者：
Rabitti, Carla
中科院分区：
文献类型：
--
作者：
Altomare, Vittorio;Guerriero, Gabriella;Rabitti, Carla
目的多年来，腋窝淋巴结的状况一直由腋窝淋巴结切除术来确定。然而，前哨淋巴结活检已被证明可以有效地取代腋窝淋巴结切除术，以确定腋窝分期的需要。本研究提出的初步结果细针穿刺细胞学（FNAC）的有效性，以确定转移性腋窝淋巴结在术前phase.Methods 100例淋巴结组织学和细胞学证实的乳腺癌（cT 1 -2 cN 0）进行超声引导下细针穿刺细胞学检查。诊断准确率以前哨淋巴结活检和腋窝淋巴结清扫术的病理结果为参照，评价前哨淋巴结活检对腋窝淋巴结转移的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。敏感性68%，特异性100%，阳性预测值100%，阴性预测值65%。回声引导下的腋窝淋巴结细针穿刺活检，因此应包括在定期的术前staging.Conclusion诊断程序，这种简单，廉价，微创技术，可以避免前哨淋巴结活检的额外费用，同时也节省了病人的压力，进行第二次手术。
Purpose For many years, the status of the axillary lymph nodes has been determined by an axillary lymphadenectomy. However, a sentinel lymph node biopsy has been shown to effectively replace the need for an axillary lymphadenectomy in order to determine the axillary staging. This study presents the preliminary results regarding the efficacy of fine-needle aspiration cytology (FNAC) to identify metastatic axillary lymph nodes in the pre-operative phase.Methods One hundred lymph nodes from 100 patients with histologically and cytologically confirmed breast cancer (cT1-2 cN0) underwent echo-guided FNAC. The diagnostic accuracy (sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV]) for the axillary metastases was evaluated based on the histological findings of either a sentinel lymph node biopsy or an axillary lymphadenectomy as a reference standard.Results It was possible to avoid a sentinel lymph node biopsy in 30% of the cases; the sensitivity was 68%, specificity 100%, PPV 100%, and NPV 65%. Echo-guided FNAC of the axillary lymph nodes should thus be included among the regular diagnostic procedures of presurgical staging.Conclusion This simple, inexpensive, and minimally invasive technique makes it possible to avoid the additional cost of a sentinel lymph node biopsy while also sparing the patient the stress of undergoing a second surgery.