title: Comparison of sonography with sonographically guided fine-needle aspiration biopsy and core-needle biopsy for initial axillary staging of breast cancer.
abstract: OBJECTIVE
  The purpose of this study was to determine the roles of sonography and sonographically guided fine-needle aspiration biopsy and core-needle biopsy for initial axillary staging of breast cancer.
  
  
  METHODS
  Of 220 patients with breast cancer who underwent preoperative or prechemotherapy sonography for axillary staging, 52 patients who underwent sonographically guided fine-needle aspiration biopsy and core-needle biopsy for cortical thickening or a compressed hilum of lymph nodes on sonography were prospectively enrolled. Sonography and fine-needle aspiration biopsy/core-needle biopsy findings were compared with final pathologic results from sentinel lymph node biopsy or axillary lymph node dissection.
  
  
  RESULTS
  Forty-eight patients met the final study criteria; we excluded 4 who had received primary systemic chemotherapy and showed negative fine-needle aspiration biopsy/core-needle biopsy results and negative final postoperative pathologic results. The positive predictive value of axillary sonography was 54%. The sensitivity and specificity of fine-needle aspiration biopsy were 73% and 100%, respectively, and those of core-needle biopsy were 77% and 100%. Results did not differ significantly between sonographically guided core-needle biopsy and fine-needle aspiration biopsy. The complication rates of fine-needle aspiration biopsy and core-needle biopsy were both 4%, and fine-needle aspiration biopsy and core-needle biopsy cost $180 and $350, respectively.
  
  
  CONCLUSIONS
  Both sonographically guided fine-needle aspiration biopsy and core-needle biopsy were useful for axillary staging of breast cancer with high sensitivity. However, fine-needle aspiration biopsy is recommended based on the advantages of low cost and minimal invasiveness.
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Korea. kimsmlms@daum.net.
authors.forename: Hye Shin
authors.initials: HS
authors.lastname: Ahn
authors.forename: Sun Mi
authors.initials: SM
authors.lastname: Kim
authors.forename: Mijung
authors.initials: M
authors.lastname: Jang
authors.forename: Bo
authors.initials: B
authors.lastname: La Yun
authors.forename: Sung-Won
authors.initials: SW
authors.lastname: Kim
authors.forename: Eunyoung
authors.initials: E
authors.lastname: Kang
authors.forename: So Yeon
authors.initials: SY
authors.lastname: Park
authors.forename: Woo Kyung
authors.initials: WK
authors.lastname: Moon
authors.forename: Hye Young
authors.initials: HY
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla; D062005:Biopsy, Large-Core Needle / Q000379:methods*; D001943:Breast Neoplasms / Q000473:pathology*; D002277:Carcinoma / Q000473:pathology* / Q000556:secondary*; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011859:Radiography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D016217:Ultrasonography, Mammary / Q000379:methods*
keywords: axillary lymph node; breast cancer; core needle biopsy; fine-needle aspiration biopsy; sonography