title: The impact of method of biopsy on the incidence of breast cancer sentinel lymph node metastases.
abstract: BACKGROUND
  The dislocation of the malignant cells along the needle tract during breast cancer (BC) diagnosis has been demonstrated by several studies. However, the published experiences that relate the diagnostic technique with sentinel node (SN) involvement are few and controversial. The aim of our analysis was to evaluate the impact of different techniques for preoperative BC biopsy among prognostic factors of metastases occurrence in SN.
  
  
  METHODS
  We reviewed the institutional clinical database of our Center. A total of 674 patients were diagnosed between February 1999 and December 2006 with invasive BC. SN metastases classification followed the 2002 American Joint Committee on Cancer (AJCC) TNM pathological staging: macrometastases, micrometastases, isolated tumor cells or negative. Only macrometastases and micrometastases were considered positive. Concerning fine-needle aspiration cytology, we used disposable needles of the size of 21-27 G. For percutaneous biopsy we used cutting needle type "tru-cut"; the Gauge needle ranged between 14 and 20.
  
  
  RESULTS
  At univariate analysis of specific parameters using positive SN as outcome, percutaneous diagnostic technique did not affect significantly the SN positivity (p = 0.60). At multivariate models only central quadrant lesion (p = 0.005) and lymph vascular invasion (LVI) presence (p < 0.0001) maintained the statistical significance as risk factor for positive SN status. Polytomic logistics models showed that only LVI maintained the statistical significance both for prediction of micrometastases and macrometastases.
  
  
  CONCLUSIONS
  Our analysis showed that different techniques used for BC diagnosis did not influence SN status.
authors.affiliation: Radiotherapy Unit, University of Florence, Florence, Italy. Electronic address: icro.meattini@unifi.it.
authors.forename: I
authors.initials: I
authors.lastname: Meattini
authors.affiliation: Diagnostic Senology Unit, University of Florence, Florence, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Giannotti
authors.affiliation: Diagnostic Senology Unit, University of Florence, Florence, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Abdulcadir
authors.affiliation: Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Center (ISPO), University of Florence, Florence, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Saieva
authors.affiliation: Breast Radiology Service, Policlinico Hospital, Bari, Italy.
authors.forename: A M
authors.initials: AM
authors.lastname: Guerrieri
authors.affiliation: Diagnostic Senology Unit, University of Florence, Florence, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Vanzi
authors.affiliation: Radiotherapy Unit, University of Florence, Florence, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Scartoni
authors.affiliation: Radiotherapy Unit, University of Florence, Florence, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Cecchini
authors.affiliation: Department of Surgery, University of Florence, Florence, Italy.
authors.forename: L J
authors.initials: LJ
authors.lastname: Sanchez
authors.affiliation: Department of Surgery, University of Florence, Florence, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Orzalesi
authors.affiliation: Department of Surgery, University of Florence, Florence, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Casella
authors.affiliation: Department of Pathology, University of Florence, Florence, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Bianchi
authors.affiliation: Radiotherapy Unit, University of Florence, Florence, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Livi
authors.affiliation: Diagnostic Senology Unit, University of Florence, Florence, Italy.
authors.forename: J
authors.initials: J
authors.lastname: Nori
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D044963:Biopsy, Fine-Needle / Q000009:adverse effects / Q000379:methods; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D016009:Chi-Square Distribution; D015331:Cohort Studies; D016208:Databases, Factual; D004209:Disposable Equipment; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D061206:Neoplasm Micrometastasis / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000473:pathology; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000473:pathology; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D021701:Sentinel Lymph Node Biopsy / Q000009:adverse effects* / Q000379:methods*; D016019:Survival Analysis
keywords: Breast cancer; Macrometastases; Micrometastases; Percutaneous bioptic technique; Radiotherapy; Sentinel node