Diagnosis of lymph node metastases by axillary node core biopsy in patients presenting with primary operable breast cancer

Preoperative diagnosis of axillary nodal metastases allows selective axillary clearance in patients with confirmed nodal metastases. This study examines the utility of ultrasound guided core biopsy of abnormal axillary nodes in patients presenting with operable breast cancer.

All patients presenting with suspected operable breast cancer had their axilla scanned. Nodes were classified as abnormal if the AP/width ratio was less than 2 or a focally thickened cortex was seen. Abnormal nodes underwent ultrasound guided core biopsy except a few where fine-needle aspiration (FNA) was performed due to the proximity of axillary vessels.

In 50 women nodes were seen in 30, of which 17 were abnormal. Thirteen cores and four FNAs were performed. Nine (69%) of 13 cores were malignant and one of four FNAs were malignant. Correlation with surgical histology will be performed.

Ultrasound can identify abnormal nodes in women with breast cancer. Most of these nodes are malignant and this can be confirmed with ultrasound guided core biopsy.