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False Negative Results in Axillary Lymph Nodes by Ultrasonography and Ultrasonography-Guided Fine-Needle Aspiration in Patients with Invasive Ductal Carcinoma

 S. H. Park  ;  E.-K. Kim  ;  B.-W. Park  ;  S. I. Kim  ;  H. J. Moon  ;  M. J. Kim 
 ULTRASCHALL IN DER MEDIZIN, Vol.34(6) : 559-567, 2013 
Journal Title
Issue Date
Adult ; Aged ; Axilla ; Biopsy, Fine-Needle* ; Breast Neoplasms/diagnostic imaging* ; Breast Neoplasms/pathology* ; Breast Neoplasms/surgery ; Carcinoma, Ductal, Breast/diagnostic imaging* ; Carcinoma, Ductal, Breast/pathology* ; Carcinoma, Ductal, Breast/surgery ; False Negative Reactions ; Female ; Humans ; Infant ; Lymph Nodes/diagnostic imaging* ; Lymph Nodes/pathology* ; Lymphatic Metastasis/diagnostic imaging* ; Lymphatic Metastasis/pathology* ; Middle Aged ; Neoplasm Invasiveness/pathology ; Neoplasm Staging ; Preoperative Care ; Retrospective Studies ; Ultrasonography, Interventional*
breast ; ultrasound ; biopsy ; lymphatic
Purpose: For preoperative evaluation of ALN status using various methods, axillary US and subsequent US-FNA targeting the LNs suspicious for metastasis are the most widely used methods. The purpose of our study was to assess the rate of false-negative results at preoperative ultrasonography (US) and ultrasonography guided fine needle aspiration (US-FNA) of axillary lymph nodes (ALNs) in breast cancer patients and the number of false-negative lymph nodes, and to evaluate factors related to ALN false negative results in US and/or US-FNA in patients diagnosed with invasive ductal carcinoma. Materials and Methods: Among 317 patients who underwent surgery for invasive ductal carcinoma during 2009 in Severance hospital, 237 patients had no reported ALN metastasis on preoperative US-FNA and US. We retrospectively reviewed the subsequent surgical pathology and clinicopathologic findings and assessed the rate of false-negative results from US and US-FNA of ALN and the number of false-negative lymph node. We performed univariate analysis and multivariate logistic regression analysis to evaluate the relationships between variable clinicopathologic factors (T-stage, position of ALN, hormone receptors, histologic grade, lymphovascular invasion (LVI) and performance of FNA) and cytologic results (false-negative result; FNALN and true negative result; TNALN) from US and/or US-FNA of ALN. Results: The rate of false-negative results was 42.4 % (59/139) in both US and US-FNA of ALN but among them, 57.6 % (34/59) showed only one metastatic ALN. Breast cancer with FNALN on US and US-FNA was significantly related to positive estrogen receptor (p = 0.003), positive progesterone receptor (p = 0.001), and the presence of LVI (p = 0.004) in univariate analysis. In multivariate analysis, high T stages (≥ T2, odds ratio (OR) 4.007, p = 0.004) and LVI (OR 7.951, p = 0.001) showed significant correlation with FNALN on US and US-FNA. Conclusion: More than half of patients with FNALN showed only one metastatic ALN. LVI and high T-stages were the most important factors attributed to FNALN on US and US-FNA in patients with invasive ductal carcinoma.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Jung(김민정) ORCID logo https://orcid.org/0000-0003-4949-1237
Kim, Seung Il(김승일)
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Moon, Hee Jung(문희정) ORCID logo https://orcid.org/0000-0002-5643-5885
Park, Byeong Woo(박병우) ORCID logo https://orcid.org/0000-0003-1353-2607
Park, So Hee(박소희)
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