Clinical Usefulness of Ultrasound-Guided Fine Needle Aspiration and Core Needle Biopsy for Patients with Axillary Lymphadenopathy.

Tomoyuki Fujioka,Emi Yamaga,Goshi Oda,Yuka Yashima,Kazunori Kubota,Tsuyoshi Nakagawa,Iichiroh Onishi,Toshiyuki Ishiba,Mio Mori,Ukihide Tateishi

doi:10.3390/medicina57070722

Abstract

Background and Objectives: It is necessary to properly diagnose and manage axillary lymphadenopathy caused by a variety of diseases. This study aimed to evaluate the utility of ultrasound (US)-guided sampling in patients with axillary lymphadenopathy. Materials and Methods: Patients with axillary lymphadenopathy (excluding patients with newly diagnosed breast cancer) who underwent US-guided fine needle aspiration (FNA) or core needle biopsy (CNB) at a single center between February 2016 and September 2020 were retrospectively examined. The association between US imaging findings and malignancy was investigated and the diagnostic performance of US-guided sampling was assessed. Results: Fifty-five patients (including eight males) were included in the study; of these, 34 patients (61.8%) were finally diagnosed with a malignant lymph node lesion. Twenty-two patients (40.0%) had undergone FNA and 33 (60.0%) had undergone CNB. Larger short and long axis diameters, thicker lymph node cortex, and the absence of fatty hilum on the US were significantly associated with malignancy (p < 0.05). The diagnostic performance of FNA, CNB, and FNA + CNB was excellent (sensitivity, specificity, and accuracy of 0.909, 0.900, and 0.917 for FNA, 0.958, 1.000, and 0.970 for CNB, and 0.941, 0.952, and 0.945 for FNA + CNB, respectively). Conclusions: US-guided FNA and CNB play an important role in the diagnosis and management of patients with axillary lymphadenopathy.

Highlights

Metastasis of breast cancer is the most common cause of axillary lymphadenopathy; axillary lymphadenopathy is caused by metastasis of other malignant tumors, malignant lymphoma, hematologic malignancies, benign reactive nodes, lymphadenitis, sarcoidosis, and connective tissue diseases [3]
This retrospective study was approved by the medical ethics committee of our institution; the requirement for written informed consent of patients was waived
Of the 3600 patients who were examined by US, 152 patients were diagnosed with lymphadenopathy and underwent US-guided fine needle aspiration (FNA) or core needle biopsy (CNB) of an axillary lymph node

Summary

Introduction

US is useful for assessing the status of axillary lymph nodes as part of preoperative staging, therapy evaluation, and post-treatment surveillance of patients with breast cancer [1,2]. Clinical information and US findings can help evaluate the malignant potential of lymph node lesions, based on which, US-guided sampling can help medical professionals to arrive at a definitive diagnosis [6,7,8]. This study aimed to evaluate the utility of ultrasound (US)-guided sampling in patients with axillary lymphadenopathy. Materials and Methods: Patients with axillary lymphadenopathy (excluding patients with newly diagnosed breast cancer) who underwent US-guided fine needle aspiration (FNA) or core needle biopsy (CNB) at a single center between February 2016 and September 2020 were retrospectively examined. Conclusions: US-guided FNA and CNB play an important role in the diagnosis and management of patients with axillary lymphadenopathy

Objectives

Methods

Results