Usefulness of Ultrasound and Ultrasound-guided Fine-Needle Aspiration Biopsy for Axillary Staging in Breast Cancer: Analysis of 327 patients at a single institution

ABSTRACT

PURPOSE: To evaluate the accuracy of ultrasound (US) and US-guided fine needle aspiration biopsy (FNAB) for the diagnosis of metastasis in the axillary lymph node (LN) of patients with breast cancer. MATERIALS AND METHODS: A retrospective review of the data was performed on 327 breast cancer patients that underwent axillary US from Jun 2006 to July 2008. US-guided FNAB was performed when a LN indicated suspicious findings. Results of FNAB were compared with those of subsequent surgery. RESULTS: Of the 327 patients, 111 showed suspicious findings on US and underwent FNAB. Among the 111 cases, 73 (66%) were positive for cancer, while 38 (34%) were negative results. A Total of 254 patients who had normal findings on US (n=216) and negative results on FNAB (n=38) underwent SNB, of which 56 (22%) were proven to have metastasis. Sensitivity and specificity of US were 61.9% and 81.8%, respectively, with a positive predictive value (PPV) of 65.8% and negative predictive value (NPV) of 79.2%. Sensitivity and specificity of US-guided FNAB were 86.9% and 100%, respectively, with a PPV of 100% and a NPV of 71.7%. CONCLUSION: US and US-guided FNAB performed for axillary staging are useful methods with a high specificity and positive predictive value in invasive breast cancer patients.