title: Is Pre-Operative Axillary Staging with Ultrasound and Ultrasound-Guided Fine-Needle Aspiration Reliable in Invasive Lobular Carcinoma of the Breast?
abstract: Axillary ultrasound (US) with US-guided fine-needle aspiration (US-FNA) for suspicious lymph nodes is important for pre-operative staging and planning of surgical management. Invasive lobular carcinoma (ILC) metastases were previously thought to be difficult to detect, but with a limited amount of evidence. This study investigated the ability of US and US-FNA to detect ILC metastases by assessing 142 patients with ILC. The sensitivity of US in detection of metastasis was 52.3%, and US was able to exclude 96% of N2 and N3 axillary metastases. The false-negative rate of US-FNA in detection of metastasis for suspicious lymph nodes on US was 34.8%, and lymph nodes with longer maximal dimensions were associated with false-negative US-FNA results. Multiplicity of breast lesions and maximal cortical thickness ≥3.1 mm of lymph nodes were independently associated with metastasis. Although pre-operative US in ILC can reliably exclude advanced axillary nodal disease, US-FNA results should be carefully interpreted.
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Soo-Yeon
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Eun-Kyung
authors.initials: EK
authors.lastname: Kim
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hee Jung
authors.initials: HJ
authors.lastname: Moon
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea. Electronic address: mines@yuhs.ac.
authors.forename: Min Jung
authors.initials: MJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla / Q000000981:diagnostic imaging / Q000473:pathology; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods
keywords: Axillary lymph node metastasis; Breast; Fine-needle aspiration; Lobular carcinoma; Ultrasound