Is ultrasound-guided fine-needle aspiration cytology of adequate value in detecting breast cancer patients with three or more positive axillary lymph nodes?

G M Kramer, M W H Leenders, L J Schijf, H L S Go, T van der Ploeg, M P van den Tol, W H Schreurs

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

This study evaluated the accuracy of ultrasound-guided fine-needle aspiration cytology of the sonographically most suspicious axillary lymph node (US/FNAC) to select early breast cancer patients with three or more tumour-positive axillary lymph nodes. Between 2004 and 2014, a total of 2130 patients with histologically proven early breast cancer were evaluated and treated in the Noordwest Clinics Alkmaar. US/FNAC was performed preoperatively in all these patients. We analysed the results of US/FNAC retrospectively. Pathological axillary node status (sentinel node biopsy and/or axillary lymph node dissection) was used as reference standard. A total of 634 (29.8 %) of 2130 patients had axillary lymph node metastases on final histology. 248 node positive patients (11.6 %) had three or more positive lymph nodes. The accuracy of US/FNAC to detect three or more positive lymph nodes was 89.8 %, sensitivity was 44.8 %, specificity was 95.7 %, PPV was 58.1 %, and NPV was 92.9 %. This study shows a more than adequate accuracy of preoperative US/FNAC to detect three or more positive lymph nodes (89.8 %). However, when US/FNAC was chosen as the only axillary staging method, 6.4 % of all patients (false negative group) would have been undertreated and 3.8 % of all patients (false positive group) would have been overtreated according to the ACOSOG Z0011 criteria.

Original languageEnglish
Pages (from-to)271-8
Number of pages8
JournalBreast Cancer Research and Treatment
Volume156
Issue number2
DOIs
Publication statusPublished - Apr 2016

Cite this

@article{5ff2c3e275f244e18509de65191f13d8,
title = "Is ultrasound-guided fine-needle aspiration cytology of adequate value in detecting breast cancer patients with three or more positive axillary lymph nodes?",
abstract = "This study evaluated the accuracy of ultrasound-guided fine-needle aspiration cytology of the sonographically most suspicious axillary lymph node (US/FNAC) to select early breast cancer patients with three or more tumour-positive axillary lymph nodes. Between 2004 and 2014, a total of 2130 patients with histologically proven early breast cancer were evaluated and treated in the Noordwest Clinics Alkmaar. US/FNAC was performed preoperatively in all these patients. We analysed the results of US/FNAC retrospectively. Pathological axillary node status (sentinel node biopsy and/or axillary lymph node dissection) was used as reference standard. A total of 634 (29.8 {\%}) of 2130 patients had axillary lymph node metastases on final histology. 248 node positive patients (11.6 {\%}) had three or more positive lymph nodes. The accuracy of US/FNAC to detect three or more positive lymph nodes was 89.8 {\%}, sensitivity was 44.8 {\%}, specificity was 95.7 {\%}, PPV was 58.1 {\%}, and NPV was 92.9 {\%}. This study shows a more than adequate accuracy of preoperative US/FNAC to detect three or more positive lymph nodes (89.8 {\%}). However, when US/FNAC was chosen as the only axillary staging method, 6.4 {\%} of all patients (false negative group) would have been undertreated and 3.8 {\%} of all patients (false positive group) would have been overtreated according to the ACOSOG Z0011 criteria.",
keywords = "Adult, Aged, Aged, 80 and over, Breast Neoplasms, Early Detection of Cancer, Female, Humans, Lymphatic Metastasis, Middle Aged, Prospective Studies, Retrospective Studies, Sensitivity and Specificity, Sentinel Lymph Node Biopsy, Journal Article",
author = "Kramer, {G M} and Leenders, {M W H} and Schijf, {L J} and Go, {H L S} and {van der Ploeg}, T and {van den Tol}, {M P} and Schreurs, {W H}",
year = "2016",
month = "4",
doi = "10.1007/s10549-016-3755-6",
language = "English",
volume = "156",
pages = "271--8",
journal = "Breast Cancer Research and Treatment",
issn = "0167-6806",
publisher = "Springer New York",
number = "2",

}

Is ultrasound-guided fine-needle aspiration cytology of adequate value in detecting breast cancer patients with three or more positive axillary lymph nodes? / Kramer, G M; Leenders, M W H; Schijf, L J; Go, H L S; van der Ploeg, T; van den Tol, M P; Schreurs, W H.

In: Breast Cancer Research and Treatment, Vol. 156, No. 2, 04.2016, p. 271-8.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Is ultrasound-guided fine-needle aspiration cytology of adequate value in detecting breast cancer patients with three or more positive axillary lymph nodes?

AU - Kramer, G M

AU - Leenders, M W H

AU - Schijf, L J

AU - Go, H L S

AU - van der Ploeg, T

AU - van den Tol, M P

AU - Schreurs, W H

PY - 2016/4

Y1 - 2016/4

N2 - This study evaluated the accuracy of ultrasound-guided fine-needle aspiration cytology of the sonographically most suspicious axillary lymph node (US/FNAC) to select early breast cancer patients with three or more tumour-positive axillary lymph nodes. Between 2004 and 2014, a total of 2130 patients with histologically proven early breast cancer were evaluated and treated in the Noordwest Clinics Alkmaar. US/FNAC was performed preoperatively in all these patients. We analysed the results of US/FNAC retrospectively. Pathological axillary node status (sentinel node biopsy and/or axillary lymph node dissection) was used as reference standard. A total of 634 (29.8 %) of 2130 patients had axillary lymph node metastases on final histology. 248 node positive patients (11.6 %) had three or more positive lymph nodes. The accuracy of US/FNAC to detect three or more positive lymph nodes was 89.8 %, sensitivity was 44.8 %, specificity was 95.7 %, PPV was 58.1 %, and NPV was 92.9 %. This study shows a more than adequate accuracy of preoperative US/FNAC to detect three or more positive lymph nodes (89.8 %). However, when US/FNAC was chosen as the only axillary staging method, 6.4 % of all patients (false negative group) would have been undertreated and 3.8 % of all patients (false positive group) would have been overtreated according to the ACOSOG Z0011 criteria.

AB - This study evaluated the accuracy of ultrasound-guided fine-needle aspiration cytology of the sonographically most suspicious axillary lymph node (US/FNAC) to select early breast cancer patients with three or more tumour-positive axillary lymph nodes. Between 2004 and 2014, a total of 2130 patients with histologically proven early breast cancer were evaluated and treated in the Noordwest Clinics Alkmaar. US/FNAC was performed preoperatively in all these patients. We analysed the results of US/FNAC retrospectively. Pathological axillary node status (sentinel node biopsy and/or axillary lymph node dissection) was used as reference standard. A total of 634 (29.8 %) of 2130 patients had axillary lymph node metastases on final histology. 248 node positive patients (11.6 %) had three or more positive lymph nodes. The accuracy of US/FNAC to detect three or more positive lymph nodes was 89.8 %, sensitivity was 44.8 %, specificity was 95.7 %, PPV was 58.1 %, and NPV was 92.9 %. This study shows a more than adequate accuracy of preoperative US/FNAC to detect three or more positive lymph nodes (89.8 %). However, when US/FNAC was chosen as the only axillary staging method, 6.4 % of all patients (false negative group) would have been undertreated and 3.8 % of all patients (false positive group) would have been overtreated according to the ACOSOG Z0011 criteria.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Breast Neoplasms

KW - Early Detection of Cancer

KW - Female

KW - Humans

KW - Lymphatic Metastasis

KW - Middle Aged

KW - Prospective Studies

KW - Retrospective Studies

KW - Sensitivity and Specificity

KW - Sentinel Lymph Node Biopsy

KW - Journal Article

U2 - 10.1007/s10549-016-3755-6

DO - 10.1007/s10549-016-3755-6

M3 - Article

VL - 156

SP - 271

EP - 278

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

SN - 0167-6806

IS - 2

ER -