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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2006

01-01-2006 | Original Article

Ultrasonography and Fine-Needle Aspiration Cytology Can Spare Breast Cancer Patients Unnecessary Sentinel Lymph Node Biopsy

Authors: Maartje C. van Rijk, MD, Eline E. Deurloo, MD, PhD, Omgo E. Nieweg, MD, PhD, Kenneth G. A. Gilhuijs, MD, PhD, Johannes L. Peterse, MD, Emiel J. T. Rutgers, MD, PhD, FRCS, Robert Kröger, MD, Bin B. R. Kroon, MD, PhD, FRCS

Published in: Annals of Surgical Oncology | Issue 1/2006

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Abstract

Background

Some 30% to 40% of the breast cancer patients scheduled for sentinel node biopsy have axillary metastasis. Pilot studies suggest that ultrasonography is useful in the preoperative detection of such nodes. The aims of this study were to evaluate the sensitivity of preoperative ultrasonography and fine-needle aspiration cytology for detecting axillary metastases and to assess how often sentinel node biopsy could be avoided.

Methods

Between October 1999 and December 2003, 726 patients with clinically negative lymph nodes were eligible for sentinel node biopsy. A total of 732 axillae were examined. Preoperative ultrasonography with subsequent fine-needle aspiration cytology in case of suspicious lymph nodes was performed in all patients. The sentinel node procedure was omitted in patients with tumor-positive axillary lymph nodes in lieu of axillary lymph node dissection.

Results

Ultrasound and fine-needle aspiration cytology established axillary metastases in 58 (8%) of the 726 patients. These 58 were 21% of the total of 271 patients who were proven to have axillary metastasis in the end. Of the patients with ultrasonographically suspicious lymph nodes and negative cytology, 31% had tumor-positive sentinel nodes. Patients with preoperatively established metastases by ultrasonography and fine-needle aspiration cytology had more tumor-positive lymph nodes (P < .001) than patients with metastases established later on.

Conclusions

The sensitivity of ultrasonography and fine-needle aspiration cytology is 21%, and unnecessary sentinel node biopsy is avoided in 8% of the patients. This approach improves the selection of patients eligible for sentinel node biopsy.
Literature
1.
Schaapveld M, Otter R, De Vries EG, et al. Variability in axillary lymph node dissection for breast cancer. J Surg Oncol 2004;87:4–12CrossRef
2.
Bland KI, Copeland EM III, eds. The Breast: Comprehensive Management of Benign and Malignant Disorders. Missouri: Saunders, 2004
3.
4.
Deurloo EE, Tanis PJ, Gilhuijs KG, et al. Reduction in the number of sentinel lymph node procedures by preoperative ultrasonography of the axilla in breast cancer. Eur J Cancer 2003;39:1068–73CrossRef
5.
De Kanter AY, Van Eijck CHJ, Van Geel AN, et al. Multicentre study of ultrasonographically guided axillary node biopsy in patients with breast cancer. Br J Surg 1999;86:1459–62CrossRef
6.
Sapino A, Cassoni P, Zanon E, et al. Ultrasonographically-guided fine-needle aspiration of axillary lymph nodes: role in breast cancer management. Br J Cancer 2003;88:702–6CrossRef
7.
Motomura K, Inaji H, Komoike Y, et al. Gamma probe and ultrasonographically-guided fine-needle aspiration biopsy of sentinel lymph nodes in breast cancer patients. Eur J Surg Oncol 2001;27:141–5CrossRef
8.
Kuenen-Boumeester V, Menke-Pluymers M, De Kanter AY, Obdeijn IM, Urich D, van der Kwast TH. Ultrasound-guided fine needle aspiration cytology of axillary lymph nodes in breast cancer patients. A preoperative staging procedure. Eur J Cancer 2003;39:170–4CrossRef
9.
Bonnema J, Van Geel AN, van Ooijen B, et al. Ultrasound-guided aspiration biopsy for detection of nonpalpable axillary node metastases in breast cancer patients: new diagnostic method. World J Surg 1997;21:270–4CrossRef
10.
Bedrosian I, Bedi D, Kuerer HM, et al. Impact of clinicopathological factors on sensitivity of axillary ultrasonography in the detection of axillary nodal metastases in patients with breast cancer. Ann Surg Oncol 2003;10:1025–30CrossRef
11.
Rutgers EJ, Meijnen P, Bonnefoi H. Clinical trials update of the European Organization for Research and Treatment of Cancer Breast Cancer Group. Breast Cancer Res 2004;6:165–9CrossRef
12.
Tanis PJ, Nieweg OE, Merkus JL, Peterse JL, Kroon BBR. False negative sentinel node procedure established through palpation of the biopsy wound. Eur J Surg Oncol 2000;26:714–5CrossRef
13.
Sener SF, Winchester DJ, Brinkmann E, et al. Failure of sentinel lymph node mapping in patients with breast cancer. J Am Coll Surg 2004;198:732–6CrossRef
14.
Wong SL, Edwards MJ, Chao C, Simpson D, McMasters KM. The effect of lymphatic tumor burden on sentinel lymph node biopsy results. Breast J 2002;8:192–8CrossRef
15.
Vargas HI, Vargas MP, Venegas R, et al. Lymphatic tumor burden negatively impacts the ability to detect the sentinel lymph node in breast cancer. Am Surg 2003;69:886–90PubMed
16.
Tanis PJ, van Sandick JW, Nieweg OE, et al. The hidden sentinel node in breast cancer. Eur J Nucl Med Mol Imaging 2002;29:305–11CrossRef
17.
Brenot-Rossi I, Houvenaeghel G, Jacquemier J, et al. Nonvisualization of axillary sentinel node during lymphoscintigraphy: is there a pathologic significance in breast cancer? J Nucl Med 2003;44:1232–7PubMed
18.
Martin RC, Fey J, Yeung H, Borgen PI, Cody HS III. Highest isotope count does not predict sentinel node positivity in all breast cancer patients. Ann Surg Oncol 2001; 8:592–7CrossRef
19.
Camp ER, Cendan JC, Feezor R, Lind DS, Wilkinson E, Copeland EM. The hottest sentinel lymph node is not always the positive node. Am Surg 2004;70:475–8PubMed
20.
Choi YD, Choi YH, Lee JH, Nam JH, Juhng SW, Choi C. Analysis of fine needle aspiration cytology of the breast: a review of 1,297 cases and correlation with histologic diagnoses. Acta Cytol 2004;48:801–6CrossRef
21.
Quiet CA, Ferguson DJ, Weichselbaum RR, Hellman S. Natural history of node-positive breast cancer: the curability of small cancers with a limited number of positive nodes. J Clin Oncol 1996;14:3105–11CrossRef
Metadata
Title
Ultrasonography and Fine-Needle Aspiration Cytology Can Spare Breast Cancer Patients Unnecessary Sentinel Lymph Node Biopsy
Authors
Maartje C. van Rijk, MD
Eline E. Deurloo, MD, PhD
Omgo E. Nieweg, MD, PhD
Kenneth G. A. Gilhuijs, MD, PhD
Johannes L. Peterse, MD
Emiel J. T. Rutgers, MD, PhD, FRCS
Robert Kröger, MD
Bin B. R. Kroon, MD, PhD, FRCS
Publication date
01-01-2006
Publisher
Springer New York
Published in
Annals of Surgical Oncology / Issue 1/2006
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/ASO.2005.01.024

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