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Volume 194, Issue 4, Pages 450-455 (October 2007)


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Utility of ultrasound and fine-needle aspiration biopsy of the axilla in the assessment of invasive lobular carcinoma of the breast

Presented at the 8th Annual Meeting of the American Society of Breast Surgeons, Phoenix, AZ, May 2–6, 2007

Judy C. Boughey, M.D.a, Lavinia P. Middleton, M.D.b, Lori Harker, P.A.-C.a, Betsy Garrett, P.A.-C.a, Bruno Fornage, M.D.c, Kelly K. Hunt, M.D.a, Gildy V. Babiera, M.D.a, Peter Dempsey, M.D.c, Isabelle Bedrosian, M.D.aCorresponding Author Informationemail address

Received 30 April 2007; received in revised form 27 June 2007

Abstract 

Background

The unique growth pattern of invasive lobular carcinoma (ILC) poses a challenge for preoperative assessment of disease extent within the breast. Whether it similarly limits lymph node staging by ultrasound (US) and fine-needle aspiration (FNA) biopsy was the subject of the current study.

Methods

A total of 217 patients with ILC who underwent axillary US were reviewed. FNA biopsy was performed when US findings were suspicious or indeterminate. Findings were compared to literature reports of US in invasive ductal carcinoma (IDC) patients.

Results

Axillary US was negative in 137 patients (63%) and suspicious or indeterminate in 80 patients (37%). FNA biopsy was positive in 62% (47/76 patients). Preoperative US and FNA biopsy identified 43 of 111 (39%) node-positive patients. Sensitivity of US with FNA biopsy correlated with primary tumor and nodal metastasis size. Similar results were seen in IDC populations.

Conclusion

US with FNA biopsy appears to be similarly useful in axillary staging of ILC and IDC patients.

a Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, 1400 Holcombe Blvd, Houston, TX 77030, USA

b Department of Pathology, The University of Texas M.D. Anderson Cancer Center, 1400 Holcombe Blvd, Houston, TX, USA

c Department of Breast Imaging, The University of Texas M.D. Anderson Cancer Center, 1400 Holcombe Blvd, Houston, TX, USA

Corresponding Author InformationCorresponding author. Tel.: +1-713-563-1872; fax: +1-713-745-1462.

PII: S0002-9610(07)00540-5

doi:10.1016/j.amjsurg.2007.06.017


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