title: Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging.
abstract: OBJECTIVE
  Diagnosis of axillary nodal involvement is significant in the management of breast cancer as well as in predicting prognosis. In this prospective study, we evaluated the efficiency of US-guided fine needle aspiration biopsy (FNAB) in preoperative axillary staging of early breast cancer.
  
  
  METHODS
  Between January 2011 and July 2013, 46 women were prospectively enrolled in the study. Ultrasound guided-FNABs for axillary assessment were performed preoperatively. Cytology results were compared with histopathology reports to determine its sensitivity, specificity, negative and positive predictive value and accuracy.
  
  
  RESULTS
  Nineteen cases that had malignant cytology on FNAB also had axillary involvement in axillary lymph node dissection (ALND) without any false-positive results. The sensitivity and specificity of US-guided FNAB were 63.3% and 100%, respectively. US-guided FNAB was accurate in predicting the status of the axilla in 76.1% of patients.
  
  
  CONCLUSIONS
  Although this technique is favorable due to its minimally invasive nature, it is not as effective as sentinel lymph node biopsy (SLNB) in terms of detecting axillary metastasis preoperatively. The low sensitivity and low accuracy rates decrease the usefulness of the technique. Therefore, it seems that US-guided FNAB alone could not replace SLNB. Nevertheless, combining some other molecular studies may be useful in increasing the technique's sensitivity. These issues should be determined by comprehensive clinical trials.
authors.affiliation: Clinic of General Surgery, Haseki Training and Research Hospital, İstanbul, Turkey.
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Akıncı
authors.affiliation: Clinic of General Surgery, Haseki Training and Research Hospital, İstanbul, Turkey.
authors.forename: Serap Pamak
authors.initials: SP
authors.lastname: Bulut
authors.affiliation: Clinic of General Surgery, Haseki Training and Research Hospital, İstanbul, Turkey.
authors.forename: Fazilet
authors.initials: F
authors.lastname: Erözgen
authors.affiliation: Clinic of Pathology, Haseki Training and Research Hospital, İstanbul, Turkey.
authors.forename: Mihriban
authors.initials: M
authors.lastname: Gürbüzel
authors.affiliation: Clinic of Radiology, Haseki Training and Research Hospital, İstanbul, Turkey.
authors.forename: Gökçe
authors.initials: G
authors.lastname: Gülşen
authors.affiliation: Clinic of General Surgery, Haseki Training and Research Hospital, İstanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kocakuşak
authors.affiliation: Clinic of General Surgery, Haseki Training and Research Hospital, İstanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Gülen
authors.affiliation: Clinic of General Surgery, Haseki Training and Research Hospital, İstanbul, Turkey.
authors.forename: Rafet
authors.initials: R
authors.lastname: Kaplan
keywords: Breast cancer; axillary fine-needle aspiration biopsy; axillary lymph node sampling; axillary staging; axillary ultrasound