Ultrasound guided needle biopsy of axilla to evaluate nodal metastasis after preoperative systemic therapy in cohort of 106 breast cancers enriched with BRCA1/2 pathogenic variant carriers

Aim of the study is to evaluate the role of ultrasound guided fine needle aspiration cytology (FNAC) in the restaging of node positive breast cancer after preoperative systemic therapy (PST). From January 2016 - October 2020 106 node positive stage IIA-IIIC breast cancer cases undergoing PST were in...

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Bibliographic Details
Published in:Hereditary cancer in clinical practice 2021-07, Vol.19 (1), p.30-30, Article 30
Main Authors: Līcīte, Baiba, Irmejs, Arvīds, Maksimenko, Jeļena, Loža, Pēteris, Trofimovičs, Genādijs, Miklaševičs, Edvīns, Nazarovs, Jurijs, Romanovska, Māra, Deičmane, Justīne, Irmejs, Reinis, Purkalne, Gunta, Gardovskis, Jānis
Format: Article
Language:English
Subjects:
Accuracy
Biopsy
BRCA1 protein
Breast cancer
Breast cancer neoadjuvant axilla cytology BRCA1/2
Cancer
Cancer therapies
Care and treatment
Cytology
Decision making
Health aspects
Hospitals
Lymph nodes
Lymphatic system
Medical research
Medicine, Experimental
Metastases
Metastasis
Pathology
Surgery
Ultrasonic imaging
Ultrasound
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Summary:Aim of the study is to evaluate the role of ultrasound guided fine needle aspiration cytology (FNAC) in the restaging of node positive breast cancer after preoperative systemic therapy (PST). From January 2016 - October 2020 106 node positive stage IIA-IIIC breast cancer cases undergoing PST were included in the study. 18 (17 %) were carriers of pathogenic variant in BRCA1/2. After PST restaging of axilla was performed with ultrasound and FNAC of the marked and/or the most suspicious axillary node. In 72/106 cases axilla conserving surgery and in 34/106 cases axillary lymph node dissection (ALND) was performed. False Positive Rate (FPR) of FNAC after PST in whole cohort and BRCA1/2 positive subgroup is 8 and 0 % and False Negative Rate (FNR) - 43 and 18 % respectively. Overall Sensitivity - 55 %, specificity- 93 %, accuracy 70 %. FNAC after PST has low FPR and is useful to predict residual axillary disease and to streamline surgical decision making regarding ALND both in BRCA1/2 positive and negative subgroups. FNR is high in overall cohort and FNAC alone are not able to predict ypCR and omission of further axillary surgery. However, FNAC performance in BRCA1/2 positive subgroup is more promising and further research with larger number of cases is necessary to confirm the results.
ISSN:1731-2302
1897-4287
1897-4287
DOI:10.1186/s13053-021-00187-w