Comparing axillary lymph node ultrasound and fine needle aspiration in breast cancer

This study investigated whether patients with a suspicious axillary lymph node (ALN) but negative fine-needle aspiration result (FNA) can be considered as having node-negative disease (AUN). The study concluded that patients with suspicious ALN on ultrasound but negative FNA results can be treated as having node-negative disease.

The axillary lymph nodes are those located under the arms. The ALNs are usually the first lymph nodes that breast cancer spreads to. Previous research has shown that ALN status is important for determining the prognosis of BC patients. It can also be used to determine treatment options with therapies such as chemotherapy or endocrine therapy.

ALNs are usually examined with an ultrasound (uses sound waves to image inside the body). FNA is a method of measuring for cancer cells in the lymph nodes. Patients with positive FNA results for ALN are commonly treated with ALN dissection, surgery to remove the lymph nodes. It is not clear whether patients with a negative FNA but suspicious nodes on ultrasound can avoid lymph node dissection.

This study examined the records of 1007 females. The patients were split into the AUN group (886 patients), which displayed ultrasound negative ALNs, and the FNA group (121 patients), who showed suspicious ALNs at ultrasound but had a negative FNA result. All patients had a biopsy to determine the presence of cancer cells.

16.5% of the AUN group and 21.5% of the FNA group had cancer positive ALNs. The AUN and FNA groups did not differ in the number of positive lymph nodes. The FNA group had similar metastatic rates and number of ALN metastases to the AUN group.

The study concluded that patients with suspicious ALN but negative FNA results can be treated as having node-negative disease.

The study relied on the use of patient records and therefore may be subject to selection bias. Further the exact number of suspicious ALNs present was not recorded; this information may have influenced the results.