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Ultrasound Fine Needle Aspiration Has High Sensitivity and Specificity for Staging Breast Cancer: Presented at SSO By Crystal Phend SAN DIEGO, C.A. -- March 27, 2006 -- Ultrasound fine needle aspiration of axillary lymph nodes to stage breast cancer may eliminate the need for sentinel lymph node biopsy, according to a study presented here at the annual meeting of the Society of Surgical Oncology (SSO). “Based on these results, we perform axillary ultrasound and fine needle aspiration on all patients with a diagnosed breast cancer and do not limit the procedure to large primary tumors or to suspicious nodes on ultrasound,” said lead author Lisa K. Jacobs, MD, assistant professor of surgery, Johns Hopkins Hospital Breast Center, Baltimore, Maryland, United States, in a presentation March 24th. Although sentinel node biopsy or axillary node dissection are typically done to stage axillary nodes, Dr. Jacobs said these methods result in treatment delays that could be reduced with ultrasound fine needle aspiration. The retrospective chart review included 68 high-risk breast cancer patients with 71 axillary nodes evaluated. Three of the patients had disease on both sides. Fine needle aspiration was performed in all patients with an adequate cortex visualized for biopsy. Of the 71 nodes evaluated, 59% were positive, 5% were suspicious but nondiagnostic, and 35% were negative by ultrasound fine needle aspiration. Compared to sentinel lymph node dissection and axillary dissection, ultrasound fine needle aspiration had 82% sensitivity and 95% specificity, which Dr. Jacobs called “pretty good” accuracy. The association between fine needle aspiration and node dissection was not statistically different for any lymph node or tumor features. Fine needle aspiration had significantly higher sensitivity than ultrasound (82.2% vs. 60.5%) and a higher specificity as well (90.0% vs. 69.6%) in predicting the node dissection result. This may have been due to the small sample size of negative axillary nodes dissected, Dr. Jacobs said. Axillary ultrasound and fine needle aspiration can be equally successful with tumors smaller and larger than 2 cm, she added. Ultrasound fine needle aspiration allows clinicians to identify cancerous nodes earlier, even when nodes do not look suspicious, Dr. Jacobs said. However, she noted that the ultrasonographer needs to be experienced in this technique to correctly stage breast cancer with this method. [Presentation title: Ultrasound Guided Fine Needle Aspiration of the Axilla for Breast Cancer Staging. Poster 62] E-mail this page to a friend or colleague! To print, use this version