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Axillary Staging by Percutaneous Biopsy: Sensitivity of Fine-Needle Aspiration Versus Core Needle Biopsy

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

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).

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgment

We thank Dr. William Brooks for guidance and Dr. Fiemu Nwariaku, Uday Yanamandra, Victoria Warren and William Lodrigues for support.

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Authors and Affiliations

  1. Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Roshni Rao MD & Valerie Andrews MD

  2. Parkland Memorial Hospital, Women’s Health Services, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Lisa Lilley NP

  3. Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Lee Radford MD & Michael Ulissey MD

Authors
  1. Roshni Rao MD
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  2. Lisa Lilley NP
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  3. Valerie Andrews MD
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  4. Lee Radford MD
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  5. Michael Ulissey MD
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Corresponding author

Correspondence to Roshni Rao MD.

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Rao, R., Lilley, L., Andrews, V. et al. Axillary Staging by Percutaneous Biopsy: Sensitivity of Fine-Needle Aspiration Versus Core Needle Biopsy. Ann Surg Oncol 16, 1170–1175 (2009). https://doi.org/10.1245/s10434-009-0421-9

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  • DOI: https://doi.org/10.1245/s10434-009-0421-9

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