Patients with suspicious axillary lymph nodes in their breasts should first undergo ultrasound-guided fine-needle aspiration to avoid unnecessary surgery

May 17 2005

Patients with suspicious axillary lymph nodes in their breasts should first undergo ultrasound-guided fine-needle aspiration to avoid unnecessary surgery, according to researchers from the Evangelico Valdese Hospital in Turin, Italy.

Currently, breast cancer patients undergo axillary lymph node dissection for accurate staging and control of the cancer. In many cases, this major procedure can be replaced by sentinel lymph node biopsy, which is a more simple and less invasive surgical procedure, but many still have to undergo axillary dissection after the sentinel lymph node biopsy.

By having fine-needle aspiration, those patients whose results turn out metastatic can forego sentinel lymph node biopsy for axillary dissection or chemotherapy. “Fine-needle aspiration allows considerable savings in terms of money, time and effort because it can help a patient avoid unnecessary surgical procedures,” said Dr. Zanon.

Fine-needle aspiration is the sampling of cells from the body using a very thin needle. The placement of the needle is generally guided by various imaging methods. In the case of axillary lymph nodes (the nodes found in the underarm area), the procedure is guided by ultrasound. “The procedure is fast, painless and safe. No major complications are described after this procedure,” said Eugenio Zanon, MD, lead researcher of the study.

For the study, the researchers analyzed 274 cases of ultrasound-guided fine-needle aspiration of axillary lymph nodes in patients suspected of having breast cancer. A total of 109 of the fine-needle aspirations turned out positive for metastasis, and all 109 of the suspicious lymph nodes were confirmed as metastatic upon surgical dissection.

“With ultrasound-guided fine-needle aspiration, patients can receive a more precise treatment,” said Dr. Zanon.

Dr. Zanon will present the full results of the study on May 17 during the American Roentgen Ray Society Annual Meeting in New Orleans, LA.