Changing role of the fine needle aspiration biopsy in breast screening

Abstract

s / The Breast 24 (2015) 302e307 306 with 1-2 positive sentinel nodes is unnecessary. This study aims to quantify the trends pre and post the landmark paper and its impact in Auckland, New Zealand. Methods: We performed a retrospective review of all women who underwent lumpectomy or mastectomy and sentinel node biopsy for T1-T2 breast cancer between January 2009 and June 2012 in Auckland. We identified patients who would fulfill the Z0011 inclusion criteria and compared the rate of AND pre and post February 2011when the Z0011 trial was published. Results: Only 7.5% of clinical T1/T2, N0, M0 invasive breast cancer patients would fulfill the criteria of Z0011. The rate of progression to AND significantly dropped in the time period post publication of Z0011 (89.6% pre, 65.5% post, P1⁄40.0005). This result was again seen in patients with micrometastatic disease only (68.2% pre, 38.6% post, P1⁄40.0148). There were no significant differences in patient or tumor characteristics between the two groups. Further metastatic nodes were detected pathologically in 40.2% of patients who had an AND. Conclusions: The trend in this patient subgroup is likely to be explained by increasing evidence against completion AND in macro and micrometastatic sentinel node disease. This signifies a substantial reduction in morbidity associated with AND for these patients. However the findings remain applicable to only a small proportion of breast cancer patients. CHANGING ROLE OF THE FINE NEEDLE ASPIRATION BIOPSY IN BREAST SCREENING