Utility of ultrasound and fine-needle aspiration biopsy of the axilla in the assessment of invasive lobular carcinoma of the breast

Boughey, Judy C.; Middleton, Lavinia P.; Harker, Lori; Garrett, Betsy; Fornage, Bruno; Hunt, Kelly K.; Babiera, Gildy V.; Dempsey, Peter; Bedrosian, Isabelle

doi:10.1016/j.amjsurg.2007.06.017

« Previous Next »The American Journal of Surgery
Volume 194, Issue 4 , Pages 450-455, October 2007

Utility of ultrasound and fine-needle aspiration biopsy of the axilla in the assessment of invasive lobular carcinoma of the breast

Presented at the 8th Annual Meeting of the American Society of Breast Surgeons, Phoenix, AZ, May 2–6, 2007

Judy C. Boughey, M.D.
- Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, 1400 Holcombe Blvd, Houston, TX 77030, USA
Lavinia P. Middleton, M.D.
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, 1400 Holcombe Blvd, Houston, TX, USA
Lori Harker, P.A.-C.
- Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, 1400 Holcombe Blvd, Houston, TX 77030, USA
Betsy Garrett, P.A.-C.
- Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, 1400 Holcombe Blvd, Houston, TX 77030, USA
Bruno Fornage, M.D.
- Department of Breast Imaging, The University of Texas M.D. Anderson Cancer Center, 1400 Holcombe Blvd, Houston, TX, USA
Kelly K. Hunt, M.D.
- Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, 1400 Holcombe Blvd, Houston, TX 77030, USA
Gildy V. Babiera, M.D.
- Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, 1400 Holcombe Blvd, Houston, TX 77030, USA
Peter Dempsey, M.D.
- Department of Breast Imaging, The University of Texas M.D. Anderson Cancer Center, 1400 Holcombe Blvd, Houston, TX, USA
Isabelle Bedrosian, M.D.
- Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, 1400 Holcombe Blvd, Houston, TX 77030, USA
- Corresponding author. Tel.: +1-713-563-1872; fax: +1-713-745-1462.

Received 30 April 2007; received in revised form 27 June 2007

Abstract

Background

The unique growth pattern of invasive lobular carcinoma (ILC) poses a challenge for preoperative assessment of disease extent within the breast. Whether it similarly limits lymph node staging by ultrasound (US) and fine-needle aspiration (FNA) biopsy was the subject of the current study.

Methods

A total of 217 patients with ILC who underwent axillary US were reviewed. FNA biopsy was performed when US findings were suspicious or indeterminate. Findings were compared to literature reports of US in invasive ductal carcinoma (IDC) patients.

Results

Axillary US was negative in 137 patients (63%) and suspicious or indeterminate in 80 patients (37%). FNA biopsy was positive in 62% (47/76 patients). Preoperative US and FNA biopsy identified 43 of 111 (39%) node-positive patients. Sensitivity of US with FNA biopsy correlated with primary tumor and nodal metastasis size. Similar results were seen in IDC populations.