US-guided core-needle breast biopsy OK for preop staging

Tuesday, November 27 | 3:20 p.m.-3:30 p.m. | SSJ01-03 | Arie Crown Theater
Which is better for assessing metastasis in newly diagnosed breast cancer: fine-needle aspiration or core biopsy? It's an important question, according to Finnish researchers, as the presence of axillary metastasis is the most significant prognostic factor in invasive breast cancer.

Past studies have shown that ultrasound-guided core biopsy results have a slight advantage over fine-needle aspiration, but no prospective, comparative studies of the two methods are available in the same patient population, according to study presenter Dr. Suvi Rautiainen of Kuopio University Hospital. Rautiainen's team compared the accuracy of axillary fine-needle aspiration to core-needle biopsy in the preoperative evaluation of women with invasive breast cancer.

The study included 120 consecutive invasive breast cancer patients, diagnosed between April 2011 and March 2012. Each woman's most suspicious lymph node was biopsied first with fine-needle aspiration, followed by core-needle biopsy; patients with positive findings were sent directly to axillary lymph node dissection, while those with negative findings went to sentinel lymph node biopsy.

Of the 124 discovered axillae, 52 were found to have metastasis, the researchers found. The sensitivity of core-needle biopsy was 90.6%, significantly higher than that of fine-needle aspiration, at 71.9%. Both techniques had 100% specificity.

The study results suggest that ultrasound-guided axillary lymph node core-needle biopsy is the more effective diagnostic procedure in the preoperative staging of invasive breast cancer patients, according to Rautiainen and colleagues.

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