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ISRN Oncology
Volume 2014 (2014), Article ID 703160, 9 pages
http://dx.doi.org/10.1155/2014/703160
Clinical Study

Ultrasound Guided Core Biopsy versus Fine Needle Aspiration for Evaluation of Axillary Lymphadenopathy in Patients with Breast Cancer

1Department of Radiology at Magee-Womens Hospital of the University of Pittsburgh Medical Center, 300 Halket Street, Pittsburgh, PA 15213, USA
2Department of Pathology, Mills-Peninsula Hospital of Sutter Health Affiliate, 383 East Grand Avenue suite A, South San Francisco, CA 94080, USA
3Department of Pathology at Magee-Womens Hospital of the University of Pittsburgh Medical Center, 300 Halket Street, Pittsburgh, PA 15213, USA
4Department of Biostatistics, University of Pittsburgh, Graduate School of Public Health, A414 Crabtree Hall, 130 DeSoto Street, Pittsburgh, PA 15213, USA

Received 23 September 2013; Accepted 24 November 2013; Published 4 February 2014

Academic Editors: K. H. Tkaczuk and T. Yokoe

Copyright © 2014 Marie A. Ganott et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Rationale and Objectives. To compare the sensitivities of ultrasound guided core biopsy and fine needle aspiration (FNA) for detection of axillary lymph node metastases in patients with a current diagnosis of ipsilateral breast cancer. Materials and Methods. From December 2008 to December 2010, 105 patients with breast cancer and abnormal appearing lymph nodes in the ipsilateral axilla consented to undergo FNA of an axillary node immediately followed by core biopsy of the same node, both with ultrasound guidance. Experienced pathologists evaluated the aspirate cytology without knowledge of the core histology. Cytology and core biopsy results were compared to sentinel node excision or axillary dissection pathology. Sensitivities were compared using McNemar’s test. Results. Of 70 patients with axillary node metastases, FNA was positive in 55/70 (78.6%) and core was positive in 61/70 (87.1%) ( ). The FNA and core results were discordant in 14/70 (20%) patients. Ten cases were FNA negative/core positive. Four cases were FNA positive/core negative. Conclusion. Core biopsy detected six (8.6%) more cases of metastatic lymphadenopathy than FNA but the difference in sensitivities was not statistically significant. Core biopsy should be considered if the node is clearly imaged and readily accessible. FNA is a good alternative when a smaller needle is desired due to node location or other patient factors. This trial is registered with NCT01920139.