Comparison Of Ultrasound With Ultrasound-Guided Fine-Needle Aspiration Biopsy And Core Needle Biopsy For Initial Axillary Staging Of Breast Cancer Patients.

96 Background: The sensitivity and specificity of FNAB and CNB performed in suspicious axillary LNs have ranged from 56% to 86% and from 91% to 100%, because FNAB and CNB are operator- and institution-dependent procedures. In addition, previous studies concerning the diagnostic accuracy of these procedures have reported results from only FNAB or CNB. So, the purpose of this study was to determine the diagnostic accuracy of axillary US and compare that of US-guided FNAB with CNB for axillary staging in the same breast cancer population.Of 220 breast cancer patients who underwent preoperative or prechemotherapy axillary US for axillary staging, 52 patients who underwent US-guided FNAB and CNB of cortical thickening and/or compressed hilum of lymph nodes on US were prospectively enrolled. US and FNAB/CNB findings were compared with final pathology from sentinel lymph node biopsy or axillary lymph node dissection.Forty-eight patients met the final study criteria; we excluded 4 who had received primary systemic chemotherapy and showed negative FNAB/CNB results with negative final post-operative pathology. Positive predictive value (PPV) of axillary US was 54%. The sensitivity and specificity of FNAB were 73% and 100%, and those of CNB were 77% and 100%. Results did not significantly differ between US-guided CNB and FNAB. The complication rates of FNAB and CNB were 4%, and FNAB and CNB cost $180 and $350, respectively.Both US-guided CNB and FNAB were useful for axillary staging in breast cancer patients with high sensitivity. However, FNAB is recommended based on the advantages of low cost and minimal invasiveness.