title: Use of axillary ultrasound, ultrasound-fine needle aspiration biopsy and magnetic resonance imaging in the preoperative triage of breast cancer patients considered for sentinel node biopsy.
abstract: We assessed the diagnostic yield of axillary ultrasound, alone or in combination with fine-needle aspiration axillary biopsy and magnetic resonance imaging in patients with invasive breast carcinoma compared with final axillary histology by sentinel node biopsy or by axillary lymph node dissection. From January 2003 to March 2009, 520 axillary ultrasound examinations and 105 axillary magnetic resonance imaging studies were included. Compared with final axillary histology, ultrasound fine-needle aspiration showed positive predictive value of 87%, negative predictive value of 82%, sensitivity of 53% and specificity of 100%. In cases of negative ultrasound, the rate of positive nodes was 17% (micro-metastases excluded). Ultrasound examination of the axilla, combined with fine-needle aspiration as appropriate must be included in the preoperative work-up of patients considered for sentinel node biopsy to definitively establish such an indication while minimizing the risk of false-negative sentinel node. Axillary magnetic resonance imaging did not improve the preoperative work-up.
authors.affiliation: Breast Unit, Department of Gynecology, University Hospital of Mútua Terrassa, Research Foundation Mútua Terrassa, University of Barcelona, Spain. agarcia@mutuaterrassa.es
authors.forename: Antonio
authors.initials: A
authors.lastname: García Fernández
authors.forename: M
authors.initials: M
authors.lastname: Fraile
authors.forename: N
authors.initials: N
authors.lastname: Giménez
authors.forename: A
authors.initials: A
authors.lastname: Reñe
authors.forename: M
authors.initials: M
authors.lastname: Torras
authors.forename: L
authors.initials: L
authors.lastname: Canales
authors.forename: J
authors.initials: J
authors.lastname: Torres
authors.forename: I
authors.initials: I
authors.lastname: Barco
authors.forename: S
authors.initials: S
authors.lastname: González
authors.forename: E
authors.initials: E
authors.lastname: Veloso
authors.forename: C
authors.initials: C
authors.lastname: González
authors.forename: L
authors.initials: L
authors.lastname: Cirera
authors.forename: A
authors.initials: A
authors.lastname: Pessarrodona
mesh_terms: D001365:Axilla / Q000000981:diagnostic imaging* / Q000473:pathology; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy; D014463:Ultrasonography