García-Hernández GD, Ríos-Rodríguez N, Tenorio-Flores E, Garcia-Blanco MC

Language: Spanish
References: 14
Page: 14-19
PDF size: 286.87 Kb.

ABSTRACT

Introduction: the axillary lymph nodes are the most common location of metastasis; the prevalence of axillary compromise is between 40 and 70%; the state of the axillary lymph nodes has shown to be the most important value to predict overall and disease-free survival in patients with breast cancer.
Objetive: a retrospective study to reconsider the diagnostic validity of ultrasound-guided fine needle aspiration biopsy of the axillary lymph nodes as an accessible and economic staging method in patients with breast cancer.
Material and Methods: we conducted a retrospective analysis of 248 cytology tests of axillary lymph nodes, obtained by ultrasoundguided fine needle aspiration, at the Hospital General de Mexico Dr. Eduardo Liceaga Mammography Service, in patients with suspected metastasis of breast cancer; in the period between January 2010 and July 2016. The statistical results were compared with those obtained by pathology at the Oncological Surgery Service from 266 samples taken by selective sentinel lymph node biopsy in the same period.
Results: 770 fine needle axillary lymph node biopsies were taken, of which 207 were ultrasound guided; of those, 138 tested positive for metastasis, 50 negative for neoplastic cells, and 19 were classified as insufficient samples; also, 243 selective sentinel lymph node biopsies were taken, of which 166 tested positive for metastasis; the rest were normal or without cellular atypia.
Conclusions: sensitivity, specificity, accessibility, and low cost of ultrasound-guided axillary lymph node aspiration make it a suitable method to evaluate the axillary lymph nodes in patients with breast cancer.

REFERENCES

1. Robles S. Galani E. El cáncer de mama en américa latina y el caribe. Rev. Panam. salud pública 2012;12:141-3.

2. Cardenas J, Bargallo E, Arazo A, Maafs E, Poitevin A et al. Consejo Mexicano sobre diagnóstico y tratamiento del cáncer de mama. 2013 Ene. 5ª edición.: 5-17.

3. Norma Oficial Mexicana NOM-041-SSA-2-2011 para la Prevención, Diagnóstico, Tratamiento, Control y Vigilancia Epidemiológica del Cáncer de Mama, México, Secretaría de Salud 2003:6-7.

4. Martel C, Ferlay J, Franceschi S, et al. Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. The Lancet Oncology 2012;13: 607- 615.Greene FL, Page DL, Fleming ID, AJCC Cancer Staging Manual. 6th ed. New York: Springer; 2002.

5. Singletary SE, Allred C, Ashley P, Bassett LW, Barry D, Bland KI, et al. Revision of the American Joint Committee on Cancer staging system for breast cancer. J.Clin.Oncol.2002 Sep.1;20(17):3628-3636.

6. Anderson BO et al. (2008). Guideline implementation for breast healthcare in low-income and middle-income countries: overview of the Breast Health Global Initiative Global Summit 2007. Cancer, 113,2221–43.

7. Rahbar G, Sie AC, Hansen GC, Prince JS, Melany ML, Reynolds HE, et al. Benign versus malignant solid breast masses: US differentiation. Radiology 1999;213:889-94.

8. Dennis MA, Parker SH, Klauss AJ, Stavros AT, Kaske TI, Clark SB. Breast biopsy avoidance: the value of normal mammograms and normal sonograms in the setting of a palpable lump. Radiology 2001;219:186-91.

9. Bedi DG, Krishnamurthy R, Krishnamurthy S, Edeiken BS, Le-Petross H, Fornage BD, et al. Cortical morphologic features of axillary lymph nodes as a predictor of metastasis in breast cancer:in vitro sonographic study. AJR Am J. Roentgenol. 2008, Sep;191(3):646-652.

10. Feu J, Tresserra F, Fabregas R, Navarro B, Grases PJ, Suris JC, et al. Metastatic breas carcinoma in axillary lymph nodes: In vitro US detection. Radiology 1997;205(3):831- 835.

11. Susini T, Nori J, Olivieri S, Molino C, Marini G, Bianchi S, et al. Predicting the status of axillary lymph nodes in breast cancer: A multiparameter approach incluiding axillary ultrasound scanning. Breast 2009 Mar11.

12. Fisher B, Bauer M, Wickerham DL, Redmond CK, Fisher ER, Cruz AB, et al. Relation of number of positive axillary nodes to the prognosis of patients with primary breast cancer. An NSABP update. Cancer 1983 Nov 1;52(9):1551- 1557.

13. Carter CL, Allan C, Henson DE. Relation of tumor size, lymph node status, and survival in 24,740 breast cáncer casses. Cancer 1989 Jan 1;63(1):181-187.

14. Tubiana-Hulin M, Le Doussal V, Hacene K, Rouesse J, Brunet M. Sequential identification of factors predicting distant relapse in breast cancer patients treated by conservative surgery. Cancer 1993 Aug 15;72(4);1261-1271.