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Efficacy of Ultrasound-Guided Core Needle Biopsy in Detecting Metastatic Axillary Lymph Nodes in Breast Cancer
J Surg Ultrasound 2020;7:21-28
Published online November 30, 2020;  https://doi.org/10.46268/jsu.2020.7.2.21
© 2020 The Korean Surgical Ultrasound Society

Jeeyeon Lee, Ho Yong Park, Wan Wook Kim, Chan Sub Park, Minhye Jeong, Jin Hyang Jung

Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
Correspondence to: Jin Hyang Jung
Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, 807 Hoguk-ro, Buk-gu, Daegu 41404, Korea
Tel: +82-53-200-2703
Fax: +82-53-200-2072
E-mail: jjh01@knu.ac.kr
Received August 12, 2020; Revised October 8, 2020; Accepted October 14, 2020.
Journal of Surgical Ultrasound is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: Axillary lymph node status is an important prognostic factor in breast cancer. Axillary lymph nodes can be evaluated using fine-needle aspiration cytology (FNAC) or core needle biopsy (CNB) before surgery. This study compared the accuracy and false-negative rates between FNAC and CNB in patients with breast cancer who either did or did not receive neoadjuvant chemotherapy (NAC).
Methods: The clinicopathological factors of the patients were analyzed retrospectively, and the sensitivity, specificity, positive and negative predictive values, false-positive and false-negative rates, and accuracy of FNAC (n = 27) and CNB (n = 23) were compared.
Results: Regardless of whether or not NAC was performed, the CNB evaluation of the metastatic axillary lymph nodes had a 100.0% sensitivity, specificity, negative predictive value, and accuracy, except for one case with an inadequate sample. In the FNAC group, the false-negative rate was higher in patients with breast cancer who received NAC before evaluating the lymph nodes (9.1% vs. 7.7%). Moreover, ultrasound imaging was the most sensitive imaging modality that can detect the suspicious axillary lymph node.
Conclusion: CNB was more effective in evaluating the axillary lymph nodes in breast cancer than FNAC and was performed without major complications.
Keywords : Axillary lymph nodes, Biopsy, Breast cancer, Cytology


November 2020, 7 (2)