Abstract
In our Trust we classify axillary ultrasound findings as LN1 to LN5, performing fine needle aspiration cytology (FNAC) on LN3 to LN5, where LN3 represents diffuse cortical thickening (DCT) of greater than 2 mm. The resulting FNAC triages patients to either sentinel lymph node biopsy or axillary node dissection. The aim is that patients will undergo only one axillary surgical procedure. There is variation in the literature and between breast units in the DCT threshold for performing FNA, and unnecessary FNAs should be avoided. Does the resulting cytology and surgical histology validate our 2 mm threshold; or can the threshold be safely increased to 2.3 mm or 3 mm as used by some centres?
Highlights
Previous research in this centre enabled the introduction of a local protocol of nonbiopsy and discharge of women
Mammography-detected cancers were luminal in 77% (P = 0.03), node negative in 77% (P = 0.005), with ductal carcinoma in situ (DCIS) in 81% (P = 0.007)
We applied our approach to 13 experienced readers assessing 13,694 screening mammograms from a large clinical study where women are categorised as high risk if they have a 5 to 8% 10-year risk computed by a validated risk model and their breast density is in the top decile of the study population
Summary
Previous research in this centre enabled the introduction of a local protocol of nonbiopsy and discharge of women
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