Fine needle aspiration cytology guided by ultrasound of suspicious axillary lymph nodes in breast cancer patients.

Abstract

Purpose: The preoperative diagnosis of axillary status by means of Fine Needle Aspiration (FNA) guided by ultrasound is a method to obtain information on axillary lymph node status allowing decision about management of the axilla. This is a cross-sectional study aiming to analyze the use of ultrasound guided FNA for axillary lymph nodes and to determine the usefulness of this method in the preoperative staging of breast cancer patients candidates for sentinel lymph node biopsy (SNB). Methods: Ultrasound guided FNA were performed in 41 patients who had presented abnormal alterations in axillary lymph nodes. Patients with malignant cytology avoided SNB and were submitted directly to axillary lymph node dissection (ALND), patients with negative cytology held SNB. The histological findings were compared with the results of ultrasound guided FNA. Results: In evaluating FNA cytology, 18 (43.90%) patients presented cytology compatible with malignancy and 23 (56.10%) were benign. The axillary ultrasound guided FNA demonstrated a sensitivity of 81.8%, specificity of 100%, positive predictive value (PPV) of 100%, negative predictive value (NPV) of 82.6% and 90,2% of accuracy. Conclusion: The data demonstrate that the FNA is an effective procedure in preoperative assessment in patients with breast cancer.