PREOPERATIVE FINE NEEDLE ASPIRATION OF AXILLARY LYMPH NODES IN BREAST CANCER: CLINICAL UTILITY, DIAGNOSTIC ACCURACY AND POTENTIAL PITFALLS

Presenter: Dr. RAJINI T Moderator : Dr. SURESH T.N

INTRODUCTION

Axillary lymph node metastasis is an important prognostic factor for breast cancer patients.

Preoperative evaluation of the axillary lymph node status is helpful for determining an appropriate management plan.

INTRODUCTION

Axillary lymph node FINE NEEDLE ASPIRATION (FNA) technique is used to identify cases with lymph node metastasis minimally invasive and cost-effective.

FNA cytology is imperative for obtaining an adequate amount of cytologic material to establish a preoperative diagnosisThis aids in establishing a suitable treatment plan to include Neoadjuvant chemotherapy, surgery and axillary lymph node dissection or sentinel lymph node biopsy.

INTRODUCTIONSeveral studies have reported that positive axillary lymph node FNA precludes the need for sentinel lymph node biopsy

Study was done bySyed M. Gilani, Lamia Fathallah, Basm M., Al-KhafajiDepartment of Pathology, St. John Hospital and Medical Center, Detroit, Mich, USAPublished : Acta CytologicaJune 2014Edition : 58 Page no : 248254

Objectives of the studyTo evaluate the diagnostic accuracy of axillary lymph node FNA cytology in breast cancer

To correlate it with clinical parameters/ outcomes

To identify potential pitfalls.

Materials and Methods91 breast cancer patients who had undergone axillary lymph node FNAC between January 2007 and February 2013 were obtained retrospectively from laboratory database systemInclusion criteria All cases diagnosed as breast cancer, irrespective of subtype, with subsequent follow-up axillary lymph node dissection,Exclusion criteriaThe breast cancer cases without follow-up axillary lymph node dissection

Materials and Methods

A total of 46 cases (mean age 52.6 12.7 years) had follow-up axillary dissection during the study time period. No rapid on-site evaluation (ROSE) was performed in any of the cases.All FNACs were performed using image guidance. Cytologic smears were fixed in 95% alcohol & prepared using the standard Papanicolaou stain, and, Of the 46 cases, 24 had cell block material available for review.All cases were reviewed and signed out by one of four Board-certified cytopathologists.

*