False negative results in axillary lymph nodes by ultrasonography and ultrasonography-guided fine-needle aspiration in patients with invasive ductal carcinoma

S. H. Park, Eunkyung Kim, Byeongwoo Park, S. I. Kim, H. J. Moon, minjung Kim

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13 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)559-567
Number of pages9
JournalUltraschall in der Medizin
Volume34
Issue number6
DOIs
Publication statusPublished - 2013 Dec 1

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Ductal Carcinoma
Fine Needle Biopsy
Ultrasonography
Lymph Nodes
Multivariate Analysis
Odds Ratio
Breast Neoplasms
Neoplasm Metastasis
Surgical Pathology

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

@article{fba894b5385c4986ae12129e1c1edf7e,
title = "False negative results in axillary lymph nodes by ultrasonography and ultrasonography-guided fine-needle aspiration in patients with invasive ductal carcinoma",
abstract = "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.",
author = "Park, {S. H.} and Eunkyung Kim and Byeongwoo Park and Kim, {S. I.} and Moon, {H. J.} and minjung Kim",
year = "2013",
month = "12",
day = "1",
doi = "10.1055/s-0032-1313113",
language = "English",
volume = "34",
pages = "559--567",
journal = "Ultraschall in der Medizin",
issn = "0172-4614",
publisher = "Georg Thieme Verlag",
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}

TY - JOUR

T1 - False negative results in axillary lymph nodes by ultrasonography and ultrasonography-guided fine-needle aspiration in patients with invasive ductal carcinoma

AU - Park, S. H.

AU - Kim, Eunkyung

AU - Park, Byeongwoo

AU - Kim, S. I.

AU - Moon, H. J.

AU - Kim, minjung

PY - 2013/12/1

Y1 - 2013/12/1

N2 - 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.

AB - 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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U2 - 10.1055/s-0032-1313113

DO - 10.1055/s-0032-1313113

M3 - Article

VL - 34

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EP - 567

JO - Ultraschall in der Medizin

JF - Ultraschall in der Medizin

SN - 0172-4614

IS - 6

ER -