title: The role of axillary lymph node fine needle aspiration in breast cancer staging prior to chemotherapy with histological correlation.
abstract: OBJECTIVE
  Axillary lymph node (LN) sampling is important for breast cancer staging and can be performed using fine needle aspiration (FNA). The aim of this study is to review the axillary LN FNAs performed at our institution prior to treatment, and to correlate their results with the available LN histology in order to evaluate the diagnostic utility of FNA.
  
  
  METHODS
  A total of 130 cases were retrospectively identified over a 1-year period and reviewed. The FNA findings were correlated with the histological findings in 65 (50%) LN core biopsies, 43 (33%) sentinel LN biopsies, and 22 (17%) axillary dissections.
  
  
  RESULTS
  One hundred and thirteen FNA cases (89%) correlated with the histology, while 14 cases (11%) did not correlate, including 1 false positive and 13 false negatives. Of the false-negative cases, metastases in the biopsy ranged from isolated tumor cells to 5 mm in the greatest dimension. The overall sensitivity was 85%, specificity 98%, positive predictive value 99%, and negative predictive value 75%.
  
  
  CONCLUSIONS
  Pretherapy staging of breast cancer by FNA is a useful diagnostic modality with a high specificity and positive predictive value. Due to false-negative diagnoses, a negative FNA should be followed up with further LN sampling.
authors.affiliation: Department of Pathology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA 15223, USA. monacose@upmc.edu
authors.forename: Sara E
authors.initials: SE
authors.lastname: Monaco
authors.forename: Amy
authors.initials: A
authors.lastname: Colaizzi
authors.forename: Anisa
authors.initials: A
authors.lastname: Kanbour
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: Ibrahim
authors.forename: Amal
authors.initials: A
authors.lastname: Kanbour-Shakir
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla / Q000473:pathology* / Q000601:surgery; D044963:Biopsy, Fine-Needle / Q000379:methods / Q000592:standards; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology*; D018567:Breast Neoplasms, Male / Q000188:drug therapy / Q000473:pathology; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D042361:Mammary Glands, Human / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging / Q000295:instrumentation / Q000379:methods*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods / Q000592:standards