To determine the efficacy of Fine needle aspiration cytology of axillary lymph nodes in patients with primary breast cancer using sentinel nodal biopsy as a standard reference.

Zunairah Omer, Amna Altaf, Muhammad Omer Altaf

Abstract


Abstract

Objective:

To determine the efficacy of Fine Needle Aspiration Cytology of Axillary lymph nodes in patients with primary breast cancer using sentinel nodal biopsy as a standard reference.

Place and Duration of the Study:

The study was conducted at Shaukat Khanam Memorial Hospital and Research Center Lahore from January 1st, 2014 to October 31st, 2014.

Materials and Methods:

It was a retrospective study in nature. All the patients with biopsy proven cases of unilateral primary Breast Cancer (Breast CA) having suspicious or borderline axillary node on ultrasound as per criteria were included. Those with benign nodes or treated with radiotherapy or chemotherapy in the interval between excision biopsy were not included. Fine Needle Aspiration Cytology (FNAC)  of all the included patients was done, those having positive FNAC results were subjected to Axillary Lymph Node Dissection (ALND) and the patients with negative FNAC results underwent sentinel lymph node biopsy (SLNB) after which results were evaluated.

Results:

Out of 466 patients, 323 were included in our study having definitive suspicious (186) and borderline (137) nodes groups that underwent FNAC. Those with positive FNAC results in both groups were directed to ALND all of them showed axillary node metastasis. Patients with negative FNAC results underwent SLNB, of which 94 /121 (76.7%) patients showed no nodal metastasis and only 27/121(24.3%) were positive for metastasis.

Conclusion:

FNAC has high sensitivity and specificity to determine axillary node metastasis in primary breast CA. It can be made a routine procedure to avoid a remarkable number of SLNB and choose patients for ALND as it is a simple, cost-effective and minimally invasive procedure.


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