title: Axillary fine needle aspiration cytology is a sensitive and highly specific technique for the detection of axillary lymph node metastasis: a meta-analysis and systematic review.
abstract: BACKGROUND
  Fine needle aspiration cytology (FNAC) of axillary lymphadenopathy is a helpful tool in the pre-operative diagnosis of breast cancer patients with axillary lymphadenopathy. To date, no published meta-analysis or systematic review has been performed to assess its overall value. We therefore conducted a meta-analysis to establish the overall diagnostic value of FNAC for axillary lymph node metastasis.
  
  
  METHODS
  After a review and quality assessment of 31 studies, published either in Chinese or English, the sensitivity, specificity and other measurements of accuracy of FNAC of axillary lymphadenopathy were pooled using random-effects models. A summary of the receiver-operating characteristic curves was used to summarize overall accuracy.
  
  
  RESULTS
  We provided the following estimated values for FNAC in the diagnosis of axillary lymph node metastasis: sensitivity, 0.63 [95% confidence interval (CI), 0.61-0.65]; specificity, 0.99 (95% CI, 0.99-0.99); positive likelihood ratio, 26.52 (95% CI, 18.42-38.18); negative likelihood ratio, 0.34 (95% CI, 0.29-0.40); diagnostic odds ratio, 76.73 (95% CI, 51.98-113.28).
  
  
  CONCLUSIONS
  FNAC has adequate sensitivity and high specificity in the diagnosis of axillary lymph node metastasis. A positive axillary FNA result could potentially alter disease management.
authors.affiliation: Department of Breast Surgery, Guangxi Cancer Hospital & Affiliated Cancer Hospital of Guangxi Medical University.
authors.forename: Y-H
authors.initials: YH
authors.lastname: Yu
authors.affiliation: Department of Breast Surgery, Guangxi Cancer Hospital & Affiliated Cancer Hospital of Guangxi Medical University.
authors.forename: Q-G
authors.initials: QG
authors.lastname: Mo
authors.affiliation: Department of Breast Surgery, Guangxi Cancer Hospital & Affiliated Cancer Hospital of Guangxi Medical University.
authors.forename: X
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Department of Microbiology, Guangxi Medical University.
authors.forename: L-Q
authors.initials: LQ
authors.lastname: Gao
authors.affiliation: Department of Surgery, The Third Affiliated Hospital of Guangxi Medical University.
authors.forename: C
authors.initials: C
authors.lastname: Liang
authors.affiliation: Department of Breast Surgery, Guangxi Cancer Hospital & Affiliated Cancer Hospital of Guangxi Medical University.
authors.forename: Z
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Department of Breast Surgery, Guangxi Cancer Hospital & Affiliated Cancer Hospital of Guangxi Medical University.
authors.forename: Q-H
authors.initials: QH
authors.lastname: Qin
authors.affiliation: Department of Breast Surgery, Guangxi Cancer Hospital & Affiliated Cancer Hospital of Guangxi Medical University.
authors.forename: W
authors.initials: W
authors.lastname: Wei
authors.affiliation: Department of Breast Surgery, Guangxi Cancer Hospital & Affiliated Cancer Hospital of Guangxi Medical University.
authors.forename: Y
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of Breast Surgery, Guangxi Cancer Hospital & Affiliated Cancer Hospital of Guangxi Medical University.
authors.forename: K-P
authors.initials: KP
authors.lastname: Bu
authors.affiliation: Department of Breast Surgery, Guangxi Cancer Hospital & Affiliated Cancer Hospital of Guangxi Medical University.
authors.forename: C-Y
authors.initials: CY
authors.lastname: Wei
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012680:Sensitivity and Specificity
keywords: accuracy; axillary lymphadenopathy; breast cancer; fine needle aspiration cytology; lymph node; meta-analysis