American journal of surgery · 2012
Impact of axillary ultrasound and core needle biopsy on the utility of intraoperative frozen section analysis and treatment decision making in women with invasive breast cancer.
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Caretta-Weyer Holly, Sisney Gale A, Beckman Catherine, Burnside Elizabeth S, Salkowsi Lonie R, Strigel Roberta M, Wilke Lee G, Neuman Heather B
Аннотация
BACKGROUND: Our objective was to evaluate the impact of preoperative axillary ultrasound and core needle biopsy (CNB) on breast cancer treatment decision making. A secondary aim was to evaluate the impact on the utility of intraoperative sentinel lymph node (SLN) frozen section.
METHODS: A review of 84 patients with clinically negative axilla who underwent axillary ultrasound was performed. Sensitivity, specificity, and positive/negative predictive value for axillary ultrasound with CNB was calculated.
RESULTS: Thirty-one (37%) had suspicious nodes. Of 27 amenable to CNB, 12 (14%) were malignant, changing treatment plans. The sensitivity of ultrasound and CNB was 54% and specificity 100%; the positive and negative predictive values were 100% and 80%, respectively. In 41 patients with normal ultrasounds who underwent SLN frozen section, 10 (24%) were positive.
CONCLUSIONS: Preoperative axillary ultrasound impacts treatment decision making in 14%. With a sensitivity of 54%, it is a useful adjunct to, but not replacement for, SLN biopsy. Frozen section remains of utility even after a negative axillary ultrasound.
METHODS: A review of 84 patients with clinically negative axilla who underwent axillary ultrasound was performed. Sensitivity, specificity, and positive/negative predictive value for axillary ultrasound with CNB was calculated.
RESULTS: Thirty-one (37%) had suspicious nodes. Of 27 amenable to CNB, 12 (14%) were malignant, changing treatment plans. The sensitivity of ultrasound and CNB was 54% and specificity 100%; the positive and negative predictive values were 100% and 80%, respectively. In 41 patients with normal ultrasounds who underwent SLN frozen section, 10 (24%) were positive.
CONCLUSIONS: Preoperative axillary ultrasound impacts treatment decision making in 14%. With a sensitivity of 54%, it is a useful adjunct to, but not replacement for, SLN biopsy. Frozen section remains of utility even after a negative axillary ultrasound.
Предметные рубрики MeSH
AdultAgedAged, 80 and overAxillaBiomarkers, TumorBiopsy, NeedleBreast NeoplasmsCarcinoma, Ductal, BreastFemaleFrozen SectionsHumansIntraoperative PeriodLymph NodesLymphatic MetastasisMastectomy, SegmentalMiddle AgedNeoplasm GradingNeoplasm StagingPredictive Value of TestsRetrospective StudiesSensitivity and SpecificitySentinel Lymph Node BiopsyUltrasonography