O-75 Fine needle aspiration cytology is a valuable adjunct to axillary ultrasound in the preoperative staging of early breast cancer

Morna MacNeill, Isobel Arnott, Jeremy Thomas
2010 EJC Supplements  
UK Background: While there have been a number of studies comparing axillary clearance with limited axillary surgery, there is little data available comparing axillary sample (ANS) with sentinel node biopsy (SNB). We report results of a retrospective audit of ANS and SNB procedures performed in a single unit on two sites over a 2 year period. Results: In total 224 patients underwent limited axillary surgery (ANS n = 142 (63%); SNB n = 82 (36%)) from January 2008 to January 2010. Sentinel node
more » ... psy was performed using a 28 EJC SUPPLEMENTS 8 (2010) 1-36 disease. Fewer than 20% of these patients had micrometastases alone. Tumour size and grade influenced node status in US-suspicious cases only. Conclusion: Axillary US has a moderately high PPV and NPV in preoperative axillary staging. US gives false negative results in 20% of cases and only a small proportion of these can be explained by micrometastases. Taking into account tumour size improves the predictive value of the technique. Background: The optimal management of axillary lymph node metastases from occult breast cancer (TXN1-2M0) is uncertain and practice varies in the use of primary breast radiotherapy. We conducted a retrospective review to examine clinical outcomes for patients managed with or without primary breast radiotherapy. Materials and methods: Case records from the Clinical Oncology database were reviewed to identify patients presenting with axillary nodal metastases but no detectable primary tumour for over the period between 1974 and 2003. Fifty three patients with TXN1-2M0 breast cancer were identified representing 0.4% of patients managed for breast cancer during this period. Of those tested, 59% had oestrogen receptor positive tumours. 77% received ipsilateral breast radiotherapy. Results: There was a trend towards reduced ipsilateral breast tumour recurrence in patients who received radiotherapy (16% at 5 years, 23% at 10 years) compared to those who did not (36% at 5 years, 52% at 10 years). Similarly, the locoregional recurrence rate at 5 years was 28% for patients who received radiotherapy compared to 53.7% for non irradiated patients. Breast cancer specific survival was higher (p = 0.0073; log-rank test) in patients who received ipsilateral breast radiotherapy (72% at 5 years, 66% at 10 years) compared to those who did not (58% at 5 years, 15% at 10 years). Conclusion: Primary breast radiotherapy may reduce ipsilateral breast tumour recurrence and increase survival in patients presenting with axillary lymph node metastases and occult breast primary (TXN1-2M0). Larger studies are needed to validate these findings. SLNB prior to PC will minimize risk of a false negative result and allow more accurate initial staging which can guide treatment decisions for adjuvant radiotherapy and axillary surgery.
doi:10.1016/j.ejcsup.2010.06.076 fatcat:zsghuqe2tjhojcjpbtzixnwwnq