Authors: P D Britton A Goud S Godward S Barter A Freeman M Gaskarth P Rajan R Sinnatamby J Slattery E Provenzano M O’Donovan S Pinder J R Benson P Forouhi G C Wishart
Publish Date: 2008/09/17
Volume: 19, Issue: 3, Pages: 561-569
Abstract
The aim of this study was to see how effective ultrasoundguided needle biopsy was at detecting lymph node involvement in patients with early breast cancer Patients with newly diagnosed invasive breast cancer underwent axillary ultrasound US where lymph node size and morphology were noted A core biopsy CB was undertaken of any node greater than 5 mm in longitudinal section Patients with benign CBs proceeded to sentinel lymph node SLN biopsy whereas those with malignancy underwent axillary lymph node dissection ALND US and CB findings were correlated with final surgical histology in all cases One hundred and thirtynine patients were examined of whom 525 had lymph node metastases on final histology One hundred and twentyone patients 87 underwent axillary node CB The overall sensitivity of CB for detecting lymph node metastases was 534 603 for macrometastases 267 for micrometastases The US morphological characteristics most strongly associated with malignancy were absence of a hilum and a cortical thickness greater than 4 mm However one third of patients with normal lymph node morphology had nodal metastases and only 12 of these were diagnosed on CB CB of axillary lymph nodes can diagnose a substantial number of patients with lymph node metastases allowing these patients to proceed directly to ALND avoiding unnecessary SLN biopsyThis project was generously funded by the RCR Kodak Sponsorship The authors would like to thank Dr R Warren Dr A Eleti Dr P Moyle and Dr E Senior for performing some of the axillary biopsies and the Cambridge Breast Unit Breast Care Nurse Specialists for their suggestions support and help with recruiting patients for this study GC Wishart was supported with research funding from the NIHR Cambridge Biomedical Research Centre
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