title: Axillary burden of disease following false-negative preoperative axillary evaluation.
abstract: BACKGROUND
  Preoperative axillary ultrasound (AUS) and fine-needle aspiration (FNA) are sensitive and specific for breast cancer nodal metastases. We hypothesize that false-negative result predicts minimal axillary disease (≤2 +nodes).
  
  
  METHODS
  A retrospective review of breast cancer patients receiving AUS identified T1/T2 tumors and positive sentinel node with axillary dissection. Chi-square analysis was performed using Fisher's exact test.
  
  
  RESULTS
  Of 903 AUS cases, 384 had T1/T2 tumors. False-negative rate of AUS ± FNA was 48% and 45%, respectively. Of 384 cases, 73 were sentinel node positive and had axillary dissection; 55 (75.3%) were invasive ductal carcinoma (IDC). Negative predictive value for greater than or equal to 2 nodes was 71% in IDC versus 44% for in non-IDC patients. Sixteen (29.0%) IDC patients had greater than or equal to 3 positive nodes versus 10 (55.5%) non-IDC (P = .05) patients.
  
  
  CONCLUSIONS
  The high negative predictive value for AUS with FNA for IDC suggests that the AUS plus FNA interpretation may be better limited to the ipsilateral nodes of IDC.
authors.affiliation: Comprehensive Breast Program, Division of Women's Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
authors.forename: Chantal
authors.initials: C
authors.lastname: Reyna
authors.affiliation: Comprehensive Breast Program, Division of Women's Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA. Electronic address: M.Catherine.Lee@moffitt.org.
authors.forename: Marie C
authors.initials: MC
authors.lastname: Lee
authors.affiliation: University of South Florida Morsani College of Medicine, Tampa, FL, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Frelick
authors.affiliation: Comprehensive Breast Program, Division of Women's Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
authors.forename: Nazanin
authors.initials: N
authors.lastname: Khakpour
authors.affiliation: Comprehensive Breast Program, Division of Women's Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Laronga
authors.affiliation: Comprehensive Breast Program, Division of Women's Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
authors.forename: John V
authors.initials: JV
authors.lastname: Kiluk
mesh_terms: D001365:Axilla; D044963:Biopsy, Fine-Needle / Q000379:methods*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D003937:Diagnosis, Differential; D005188:False Negative Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology*; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging / Q000379:methods; D011237:Predictive Value of Tests; D057234:Preoperative Period; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D014463:Ultrasonography
keywords: Axillary ultrasound; False negative; Pathologic burden