ABS ePoster Library

BACKGROUND: Fine needle aspiration cytology (FNAC) is performed on clinically or radiologically positive axillary nodes in breast cancer. Our study looks at the sensitivity of performing FNAC in these patients and whether positive FNAC of axillary nodes can predict the final number of involved nodes on axillary clearance (ANC).

METHOD: All primary breast cancer patients undergoing FNAC between Oct 2009 to Oct 2010 were identified from computer records. Data was collected on FNAC positivity, whether sentinel lymph node biopsy (SLNB) was performed, total number of nodes harvested and involved at ANC.

RESULTS: Of the 120 patients who underwent FNAC, 72 were positive (60%). Of those who had a negative FNAC, 29% had a positive SLNB. We compared the ANC results of those who were FNAC positive with those who were FNAC negative but SLNB positive. There was no significant difference in the mean number of harvested nodes at ANC between the two groups (mean= 17, p<0.05). There was a significant difference in the number of involved nodes in those who were FNAC positive (mean = 8 nodes) compared with those who were FNAC negative but SLNB positive (mean = 2 nodes). In those who were FNAC positive, 60% had 4 ≥ involved nodes. Patients with positive FNAC were more likely to have mastectomy over breast conservation (p= 0.49). The sensitivity of performing an FNAC was 84%

CONCLUSION: Our study provides a predictor of the number of involved axillary nodes in those with positive FNAC preoperatively. This can help to guide pre-operative discussions on the likely disease burden and need for adjuvant therapies such as chemo and radiotherapy.