Sensitivity and specificity of fine needle aspiration guided by ultrasounds to detect the sentinel lymph node. Its impact in axillary treatment of breast cancer: cross sectional study

Abstract

Background: Axillary lymph node affection in breast cancer is an important prognosis factor. The treatment of the axilla by Axillary Lymph Node Dissection (ALND) depends on the staging which is established by some complementary techniques. The presurgery staging of axillary affection is done by FNA-US and if it’s negative the SLNB is done. ALND is an aggressive procedure that nowadays is being restricted more and more. Actually in the Z0011’s era some patients with a positive SLNB aren’t undergoing the ALND. However patients with positive FNA-US must suffer the ALND procedure and its complications. If it’s proved that the positive lymph nodes detected by ultrasound are the positive sentinel lymph nodes. Early breast cancer patients with one or two positive lymph nodes by FNA-US would be able to spare the ALND as it’s done now with positive SLNB according to Z0011 trial. Purpose: The goal of the present work is to demonstrate the agreement of two diagnosis test: Sentinel Lymph Node Biopsy (SLNB) and Fine Needle Aspiration guided by Ultrasounds (US-FNA). Our principal variable is axillary metastasis. We will do an estimation of the proportion of positive lymph nodes by US-FNA that are the positive sentinel lymph nodes. So that patients would undergo same treatment decisions about sparing ALND. Design: A diagnosis test study with a cross-sectional design carried out in a tertiary referral hospital in Girona within a Breast Pathology Unit in the period of one year. Participants Women diagnosed of early and non-aggressive breast cancer that undergo US-FNA for the locoregional lymph nodes staging