Mirza S M, Hurst G, Pain S.
Role of ultrasonic guided fine-needle aspiration cytology in evaluation of axillary node status in breast cancer.
Pak J Med Health Sci Jan ;4(4):575-575.

The standard axillary treatment for breast cancer patient without clinical evidence of axillary nodes is SLNB and if positive leads to axillary clearance but this has some inherent pitfalls. The main objective of this study was to evaluate the diagnostic accuracy and utility of ultrasound guided FNAC in preoperative assessment of axillary lymph nodes and selecting those who should and should not be offered SLNB in breast cancer patients. All symptomatic or screen detected patients of breast cancer with clinically negative axilla were included in this prospective study. Of 131 patients 67 has negative axillary ultrasonography while 64 patients with suspicious nodes had FNAC and 27 turned to be positive for malignancy. Final histopathological examination revealed positive node in 57 patients: 42/64(66%) of suspicious nodes and 15/67(22%) of negative axillary ultrasonography. The U/S has sensitivity of 73% and specificity of 70% while U/S guided FNAC has sensitivity of 64% but specificity of 100%. It correctly diagnosed 27/57(47%) positive nodes and 21% of all patients where axillary clearance was performed directly without SLNB. Hence, we conclude that axillary ultrasonography and FNAC is useful diagnostic tool which will add valuable preoperative information about axillary node status, minimizing false negative rate, as well as will save cost and time by avoiding SLNB in nearly a quarter of patients.

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