Abstract
Abstract Abstract #1013 Introduction
 While the utility of ultrasound-guided axillary lymph node FNA is well established, there is a paucity of data on non-image guided office-based FNA of palpable axillary lymphadenopathy. We investigate the sensitivity and specificity of non-image guided FNA of axillary lymphadenopathy in patients presenting with breast cancer, and report factors correlating with a positive FNA result.
 Methods
 Retrospective review of 80 consecutive patients who underwent office-based FNA of palpable axillary lymph nodes between 2004-2008, with cytology results compared with histology during axillary sentinel node or lymph node dissection. Pearson correlation, chi-square and Fisher exact tests were used to determine correlation with other clinical and pathologic data.
 Results
 Mean age was 56 with a median tumor size of 2.2 cm and 39% have pNO disease. Non-image guided axillary FNA was 82% sensitive, 100% specific, and 89% accurate. Positive predictive value was 100% and negative predictive value was 76%. Therefore only 24% of patients who had a negative FNA had axillary involvement compared to 61% for the entire group.
 A significant correlation or association was identified between positive FNA cytology and breast tumor size (p=0.02), number of pathologic positive lymph nodes (p<0.0001), presentation with a palpable breast mass (p=0.003), radiographic lymphadenopathy (p=0.0005), lymphovascular invasion (p=0.003), stage of disease (P<0.0001), and N stage (p<0.0001). There was a borderline significant association with her2neu receptor status (p=0.08).
 Age, lymph node size, ER/PR status, Ki-67 index, tumor histology, multicentric disease, degree of differentiation and nuclear grade were all not significantly correlated or associated with positive FNA.
 Conclusions
 Non-image guided FNA of palpable axillary lymphadenopathy in breast cancer patients is a very sensitive and specific test. Prompt determination of lymph node positivity benefits select patients, permitting avoidance of ultrasound, sentinel lymph node biopsy, or delay in receiving neoadjuvant therapy. This results in time and cost savings for the patient and the health care system, and expedites definitive management of the patient. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1013.
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