Value of FNAC in abnormal axillary lymph nodes with non specific mammograms

Abstract

ObjectiveThis study aimed to evaluate the role of fine-needle aspiration cytology (FNAC) in the diagnosis of abnormal axillary lymph nodes identified in patients with nonspecific mammographic findings. Patients and methodsThis study included 60 patients (a mean age 52.1 years ± 15.2) with suspected abnormal axillary lymph nodes.Mammography was done using medio-lateral oblique (MLO) view. Ultrasound (US) was done as a complementary examination for all patients with an otherwise normal or benign findings on mammogram, US was done as a first diagnostic modality in patients under age of thirty. Fifty-one patients were recalled for further US guided FNAC. The other 9 patients had a known underlying diagnosis. ResultsFrom December 2014 to August 2016, A total of 60 patients (56 women and 4 men) had abnormal axillary lymph nodes with nonspecific mammogram were included; 9 patients who had a known underlying cause were not recalled for US guided biopsy. The other 51 cases required an US guided FNAC. An excisional biopsy was done in 32 cases (63%) (14 were malignant& 18 were benign). The other 19 cases (37%) had follow-up (range, 3–18 months; mean, 7.9 months).The overall diagnostic performance of FNAC in diagnosing axillary lymph adenopathy was: Sensitivity 65%; specificity, 97%; positive predictive value 93%; and negative predictive value, 81% with accuracy of 88%. The diagnostic performance of FNAC in differentiating benign from malignant axillary lymph adenopathy was: Sensitivity 85%; specificity, 97%; positive predictive value 92%; and negative predictive value, 94% with accuracy of 94%. ConclusionsFNAC was a good cytological predictor in the majority of patients with abnormal lymph nodes and nonspecific mammography. FNAC is cost effective in assessing axillary lymph node status especially in limited resource setting like in our developing country. FNAC is preferred diagnostic tool in all cases of abnormal axillary lymph adenopathy.