Volume 10 Supplement 3

Symposium Mammographicum 2008

Open Access

Ultrasound-guided axillary node core biopsy in the staging of newly diagnosed breast cancer

  • P Britton1,
  • A Goud1,
  • S Barter1,
  • A Eleti1,
  • A Freeman1,
  • M Gaskarth1,
  • P Moyle1,
  • P Rajan1,
  • R Sinnatamby1,
  • J Slattery1,
  • E Provenzano1,
  • S Pinder2,
  • S Godward3 and
  • G Wishart1
Breast Cancer Research200810(Suppl 3):P17

https://doi.org/10.1186/bcr2015

Published: 7 July 2008

One hundred and thirty-nine patients with core biopsy (CB)-proven unilateral primary operable invasive breast cancer underwent axillary ultrasound. Lymph nodes were identified on ultrasound in 134 patients (96%), of which 121 (87%) underwent core biopsy. The morphology of all biopsied nodes was noted. Normal lymph node was obtained in 77 CBs, 25 (32%) of which were subsequently shown to have nodal metastases. The results are presented in Table 1. The CB sensitivity for nodes with normal ultrasound morphology was 12%, for those with unilobulated cortex was 64%, for those with multilobulated cortex was 77%, for those with absent hilum was 88% and for those with multilobulated cortex and absent hilum was 100%.

Table 1

Number of axillas examined

139

Number of axillas where nodes identified on ultrasound

134 (96%)

Number of axillas where CB performed

121 (87%)

CB inadequate rate (%)

4.1

Lymph node-positive (surgery) (%)

52.5

CB sensitivity, all positive nodes (%)

53.4

CB sensitivity, macrometastases (%)

62.3

CB sensitivity, micrometastases (%)

8.3

In conclusion, the present study shows that an aggressive CB policy leads to an increase in sensitivity, but of relatively modest proportions, and is at the expense of a large number of normal biopsies. CB is insensitive at detecting micrometastases. CB of nodes with a normal ultrasound morphology is of little utility.

Authors’ Affiliations

(1)
Cambridge Breast Unit
(2)
Department of Pathology, Guy's King's Thomas's Hospital London
(3)
Cambridgeshire Primary Care Trust

Copyright

© BioMed Central Ltd 2008

Advertisement