caa a22 4500 445335041 CHVBK 20180317142751.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1245/s10434-010-1347-y doi (NATIONALLICENCE)springer-10.1245/s10434-010-1347-y Impact of Preoperative Ultrasonography and Fine-Needle Aspiration of Axillary Lymph Nodes on Surgical Management of Primary Breast Cancer [Elektronische Daten] [So Park, Min Kim, Byoung-Woo Park, Hee Moon, Jin Kwak, Eun-Kyung Kim] Purpose: To evaluate the accuracy of preoperative ultrasonography (US) and US-guided fine-needle aspiration (US-FNA) for detecting axillary lymph node (ALN) metastasis. Patients and Methods: We retrospectively reviewed 382 breast cancer patients with clinically negative ALN who underwent US and/or US-FNA for ALN. US-FNA of ALN was performed in 121 patients with suspicious findings on US. The diagnostic performance of US alone or with the addition of US-FNA for detecting ALN metastasis was calculated on the basis of final pathologic reports of ALN surgery. Results: Among a total of 382 patients, 129 had metastatic ALNs while 253 exhibited no signs of axillary metastasis on final pathology. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of axillary US alone were 56.6% (73/129), 81.0% (205/253), 60.3% (73/121), and 78.5% (205/261), respectively. Addition of US-FNA resulted in sensitivity, specificity, PPV, and NPV of 39.5% (51/129), 95.7% (242/253), 82.3% (51/62), and 75.6% (242/320), respectively. Excluding complete responders to neoadjuvant chemotherapy, specificity and PPV after adding US-FNA were increased to 99.6% (242/243) and 98.1% (51/52), respectively. The sensitivity and specificity of ALN metastasis were similar between the palpable and nonpalpable breast cancer groups; however, after adding US-FNA, NPV was increased in the nonpalpable breast cancer group compared with the palpable breast cancer group (p=0.0398). By including preoperative axillary US and US-FNA, 16.2% (62/382) of all breast cancer patients were able to avoid unnecessary sentinel lymph node biopsy (SLNB). Conclusions: The combination of axillary US and US-FNA is useful in preoperative work-up of breast cancer patients and provides valuable information for planning proper breast cancer management. Society of Surgical Oncology, 2010 Park So Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea aut Kim Min Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea aut Park Byoung-Woo Department of Surgery, Yonsei University College of Medicine, Seoul, Korea aut Moon Hee Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea aut Kwak Jin Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea aut Kim Eun-Kyung Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea aut Annals of Surgical Oncology Springer-Verlag 18/3(2011-03-01), 738-744 1068-9265 18:3<738 2011 18 10434 https://doi.org/10.1245/s10434-010-1347-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1347-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Park So Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Kim Min Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Park Byoung-Woo Department of Surgery, Yonsei University College of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Moon Hee Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Kwak Jin Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Kim Eun-Kyung Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/3(2011-03-01), 738-744 1068-9265 18:3<738 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer