The role of ultrasound guided core biopsy of axillary nodes in predicting macrometastases and avoiding overtreatment outside ACOSOG Z0011 parameters. Issue 1 (February 2015)

• Record Type: Journal Article
• Authors: Y.L., Jacqueline Ting; McGowan, Katherine; Cooley, Geraldine; McLaughlin, Ray; Sugrue, Michael
• Is Part Of: Breast. Volume 24:Issue 1(2015)
• Page Start: 57
• Page End: 61
• Publication Date: 2015-02
• Subjects: Ultrasound guided axillary core biopsy -- Sentinel Node -- Breast cancer -- Axillary clearance; Breast -- Diseases -- Periodicals; Breast -- Tumors -- Periodicals; Breast -- Periodicals; Electronic journals; Periodicals; 616
• DOI: 10.1016/j.breast.2014.11.007
• Languages: English
• ISSNs: 0960-9776

Abstract

Abstract: Background: Z0011 study suggests patients with minimal disease do not require axillary clearance. Exclusions include T3 tumours, mastectomy or neoadjuvant treatment. This study assessed the utility of pre-operative US-guided core biopsy of axillary nodes and its correlation with nodal macrometastases. Methods: 247 women with breast cancer outside Z0011 criteria were reviewed retrospectively. Sensitivity and specificity of pre-operative axillary ultrasound and core biopsy compared to final histology was assessed by contingency tables. Results: 75/247 patients had macrometastases. Ultrasound-axilla was 72% sensitive and 77% specific in predicting macrometastasis. The positive (PPV) and negative predictive value (NPV) was 58% and 86.4% respectively. Core-biopsy of axilla node, was 92.6% sensitive and 66.7% specific in detecting macrometastasis. PPV and NPV 79.4% and 86.7% respectively. Conclusion: Positive pre-operative ultrasound-guided core biopsy accurately predicts macroscopic involvement of axillary nodes. Selected patients outside Z0011 parameters can proceed to axillary clearance without sentinel node biopsy or risking overtreatment.