Annals of Surgical Oncology

, Volume 16, Issue 5, pp 1170–1175

Axillary Staging by Percutaneous Biopsy: Sensitivity of Fine-Needle Aspiration Versus Core Needle Biopsy

Authors

    • Department of Surgery, Division of Surgical OncologyUniversity of Texas Southwestern Medical Center
  • Lisa Lilley
    • Parkland Memorial Hospital, Women’s Health ServicesUniversity of Texas Southwestern Medical Center
  • Valerie Andrews
    • Department of Surgery, Division of Surgical OncologyUniversity of Texas Southwestern Medical Center
  • Lee Radford
    • Department of RadiologyUniversity of Texas Southwestern Medical Center
  • Michael Ulissey
    • Department of RadiologyUniversity of Texas Southwestern Medical Center
Breast Oncology

DOI: 10.1245/s10434-009-0421-9

Cite this article as:
Rao, R., Lilley, L., Andrews, V. et al. Ann Surg Oncol (2009) 16: 1170. doi:10.1245/s10434-009-0421-9

Abstract

Background

We sought to determine whether percutaneous core needle biopsy (CNB) of suspicious axillary lymph nodes in patients with breast cancer offers improved diagnostic accuracy compared with fine-needle aspiration (FNA).

Methods

Records of 400 patients were reviewed to identify patients undergoing ultrasound-guided biopsy followed by surgical axillary evaluation (sentinel lymph node biopsy or axillary lymph node dissection). Patients underwent diagnosis and treatment at a single high-volume county hospital. Data collected included demographics, treatment, biopsy, and surgical pathology. Percutaneous biopsy results were compared with results of sentinel lymph node biopsy or axillary lymph node dissection.

Results

Forty-seven patients met final study criteria. Twenty-two patients underwent FNA, and 25 underwent CNB. Sensitivity of FNA was 75% vs. 82% for CNB. Specificity for both was 100%. Additionally, a cost comparison of CNB versus FNA revealed CNB to be $404; FNA cost was $237.

Conclusions

The current data do not support the routine use of CNB over FNA for preoperative axillary staging in breast cancer patients with clinically negative axillas. Additionally, the substantial increase in cost without a marked improvement in sensitivity may favor the performance of FNA.

Copyright information

© Society of Surgical Oncology 2009