Conference Publication Details
Mandatory Fields
Balasubramanian, I;Fleming, CA;Corrigan, MA;Redmond, HP;Kerin, MJ;Lowery, AJ
BRITISH JOURNAL OF SURGERY
Meta-analysis of the diagnostic accuracy of ultrasound-guided fine-needle aspiration and core needle biopsy in diagnosing axillary lymph node metastasis
2018
September
Published
1
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BREAST-CANCER NEOADJUVANT CHEMOTHERAPY AMERICAN-COLLEGE POSITIVE NODE SENTINEL NODE TUMOR BURDEN LOCALIZATION ONCOLOGY SURGERY IMPACT
1244
1252
BackgroundAxillary lymph node status remains a significant prognostic indicator in breast cancer. Here, the diagnostic accuracy of ultrasound-guided fine-needle aspiration (US-FNA) and ultrasound-guided core needle biopsy (US-CNB) in axillary staging was compared.MethodsA comprehensive search was undertaken of all published studies comparing the diagnostic accuracy of US-CNB and US-FNA of axillary lymph nodes in breast cancer. Studies were included if raw data were available on the diagnostic performance of both US-FNA and US-CNB, and compared with final histology results. Relevant data were extracted from each study for systematic review. Meta-analysis was performed using a random-effects model. The pooled sensitivity and specificity of US-FNA and US-CNB were obtained using a bivariable model. Summary receiver operating characteristic (ROC) graphs were created to confirm diagnostic accuracy.ResultsData on a total of 1353 patients from six studies met the inclusion criteria and were included in the final analysis. US-CNB was superior to US-FNA in diagnosing axillary nodal metastases: sensitivity 88 (95 per cent c.i. 84 to 91) versus 74 (70 to 78) per cent respectively. Both US-CNB and US-FNA had a high specificity of 100 per cent. Reported complication rates were significantly higher for US-CNB compared with US-FNA (71 versus 13 per cent; P<0001). Conversely, the requirement for repeat diagnostic procedures was significantly greater for US-FNA (40 versus 05 per cent; P<0001).ConclusionUS-CNB is a superior diagnostic technique to US-FNA for axillary staging in breast cancer.
10.1002/bjs.10920
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