65PD - Significance of preoperative fine-needle aspiration biopsy for suspected cases of lymph node metastasis in primary breast cancer

Date 19 December 2016
Event ESMO Asia 2016 Congress
Session Breast cancer
Topics Breast Cancer, Early Stage
Pathology/Molecular Biology
Surgery and/or Radiotherapy of Cancer
Presenter AKIKO Ogiya
Citation Annals of Oncology (2016) 27 (suppl_9): ix19-ix29. 10.1093/annonc/mdw575
Authors A. Ogiya1, T. Iwase1, N. Teruya1, H. Sakamoto1, E. Nakashima1, A. Kataoka1, D. Kitagawa1, T. Sakai1, H. Morizono1, Y. Miyagi1, R. Horii2, F. Akiyama3, S. Ohno4
  • 1Breast Surgical Oncology, Cancer Institute Hospital of JFCR, 135-8550 - Tokyo/JP
  • 2Department Of Pathology, Cancer Institute Hospital of JFCR, 135-8550 - Tokyo/JP
  • 3Department Of Pathology, Cancer Institute of JFCR, 135-8550 - Tokyo/JP
  • 4Breast Oncology Center, Cancer Institute Hospital of JFCR, 135-8550 - Tokyo/JP

Abstract

Background

In patients diagnosed with breast cancer, preoperative assessment of the lymph nodes is performed by palpation and ultrasonography (US). In suspected cases of metastasis, the lymph nodes are evaluated by fine-needle aspiration (FNA) biopsy. In recent years, in some cases, dissections are omitted even if metastasis to the lymph nodes is detected. Thus, among cases where dissection can be omitted even when metastasis is observed, there have been some cases where dissection was initially performed when metastasis was verified by preoperative FNA. The aim of this study was to evaluate the significance of performing preoperative FNA for suspected cases of lymph node metastasis.

Methods

The study involved 745 patients with cStage I/II primary breast cancer who had undergone axillary dissection. Patients were divided into four groups based on the presence or absence of palpable lymph nodes, US findings, and FNA results: (1) the cN0 group: non-palpable lymph nodes, normal US findings, and no FNA evaluation; (2) the cN?FNA (-) group: non-palpable lymph nodes, US revealed suspicion of metastasis, and FNA revealed no metastasis; (3) the cN?FNA (+) group: non-palpable lymph nodes, US revealed suspicion of metastasis, and FNA revealed metastasis; and (4) the Stage II group: non-palpable or palpable lymph nodes, US revealed metastasis, and FNA revealed metastasis. Using the above four categories, we compared the number of lymph node metastasis in each group.

Results

The median number of lymph node metastasis in the cN0, cN?FNA (-), cN?FNA (+), and Stage II groups was 2, 2, 3, and 3, respectively. The percentage of 1-2 lymph nodes metastasis was 74%, 64%, 44%, and 46%, respectively. The percentage of ≥ 10 lymph nodes metastasis was 2%, 3%, 15%, and 11%, respectively. Distribution of the number of lymph node metastasis between the cN0 and cN?FNA (-) groups, and between the cN?FNA (-) and cN?FNA (+) groups differed significantly. In contrast, the distribution of the number of lymph node metastasis in the cN?FNA (+) and Stage II groups showed no significant differences.

Conclusions

Our study reveals that cN1 patients can be accurately identified from among those suspected of having lymph node metastasis based on FNA findings.

Clinical trial indentification

Legal entity responsible for the study

Cancer Institute Hospital, Tokyo, Japan

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.