title: Can Breast Cancer Biopsy Influence Sentinel Lymph Node Status?
abstract: We evaluated whether the needle size could influence metastasis occurrence in the axillary sentinel lymph node (SLN) in ultrasound-guided core needle biopsy (US-CNB) of breast cancer (BC).
  
  
  
  The data from all patients with breast lesions who had undergone US-CNB at our institution from January 2011 to January 2015 were retrospectively reviewed. A total of 377 BC cases were included using the following criteria: (1) percutaneous biopsy-proven invasive BC; and (2) SLN dissection with histopathologic examination. The patients were divided into 2 groups according to the needle size used: 14 gauge versus 16 or 18 gauge. SLN metastasis classification followed the 7th American Joint Committee on Cancer (2010) TNM pathologic staging factors: macrometastases, micrometastases, isolated tumor cells, or negative. Only macrometastases and micrometastases were considered positive, and the positive and negative rates were calculated for the overall population and for both needle size groups.
  
  
  
  Of the 377 BC cases, 268 US-CNB procedures were performed using a 14-gauge needle and 109 with a 16- or 18-gauge needle, respectively. The negative rate was significantly related statistically with the needle size, with a greater prevalence in the 14-gauge group on both extemporaneous analysis (P = .019) and definitive analysis (P = .002). The macrometastasis rate was 17% (63 of 377) for the 14-gauge and 3% (12 of 377) for the 16- and 18-gauge needles, respectively.
  
  
  
  Our preliminary results have suggested that use of a large needle size in CNB does not influence SLN status; thus, preoperative breast biopsy can be considered a safe procedure in the diagnosis of malignant breast lesions.
authors.affiliation: Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: micgiuli@yahoo.it.
authors.forename: Michela
authors.initials: M
authors.lastname: Giuliani
authors.affiliation: Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Patrolecco
authors.affiliation: Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Rella
authors.affiliation: Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Silvia Eleonora
authors.initials: SE
authors.lastname: Di Giovanni
authors.affiliation: Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Amato
authors.initials: A
authors.lastname: Infante
authors.affiliation: Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Rinaldi
authors.affiliation: Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Romani
authors.affiliation: Department of Pathologic Anatomy, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Mulè
authors.affiliation: Department of Pathologic Anatomy, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Damiano
authors.initials: D
authors.lastname: Arciuolo
authors.affiliation: Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Belli
authors.affiliation: Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bonomo
mesh_terms: D001365:Axilla; D044963:Biopsy, Fine-Needle / Q000009:adverse effects; D062005:Biopsy, Large-Core Needle / Q000009:adverse effects; D001707:Biopsy, Needle / Q000009:adverse effects* / Q000379:methods; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects / Q000379:methods; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D061206:Neoplasm Micrometastasis; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D000071036:Sentinel Lymph Node / Q000473:pathology / Q000601:surgery; D021701:Sentinel Lymph Node Biopsy / Q000009:adverse effects* / Q000379:methods; D016217:Ultrasonography, Mammary
keywords: Cell displacement; Dissemination; Metastases; Needle size; Ultrasound