Value of axillary ultrasound and cytology in assessing nodal status preoperatively.

Abstract

Abstract Abstract #1007 Preoperative identification of axillary node involvement in early breast cancer allows correct surgical procedures to be performed and avoids second axillary operations. We compared preoperative axillary assessment using ultrasound ± cytology with the eventual histopathological results to identify the accuracy of preoperative axillary node assessment.
 Methods: Preoperative axillary ultrasound was used to identify the presence of suspicious or malignant nodes which were then confirmed with cytological assessment to allow management decisions regarding axillary clearance (or sentinel node biopsy (SNB) if nodes appeared negative).
 Results: Overall 79/365 (21%) early breast cancer patients had suspicious or malignant nodes on ultrasound, of which 78 were confirmed on cytology, thus avoiding an unnecessary SNB operation in these patients. Ultrasound and cytology accurately identified patients with ER negative (P=≤0.001), high grade (P=≤0.001) and large size tumours ≤20mm (P=≤0.001), with involved nodes. Only 11% ER negative compared to 46% ER positive tumours were incorrectly classified (P=0.002). In contrast ER positive, low grade, small tumours were most likely to have a false negative axillary assessment. Specificity of cytological assessment of nodes was 99% and sensitivity 54%.
 Conclusions: Axillary ultrasound combined with cytological assessment of suspicious nodes accurately identifies majority of women who require axillary clearance.
 
 Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1007.