Prognostic significance of a positive axillary lymph node fine‐needle aspirate in patients with invasive breast carcinoma

BACKGROUND Image‐guided axillary lymph node fine‐needle aspirates (FNAs) correlate well with pathologic lymph node staging in cases of invasive breast carcinoma. The objective of this study was to determine the prognostic significance of a positive lymph node. METHODS Consecutive cases of nonmetastatic (M0) invasive breast carcinoma evaluated by image‐guided FNA were identified (4‐year period, median follow‐up of 51 months). “Positive” and “nonpositive” groups were compared using Kaplan‐Meier survival analysis. Multivariate Cox regression was used to correct for clinicopathologic and treatment factors. A total of 142 cases was included, 70 with positive axillary FNA and 72 with a nonpositive result. RESULTS FNA‐positive and nonpositive cases did not differ in patient age, tumor subtype, or hormone receptor status. Positive FNA was significantly associated with advanced T and N pathologic stage, and with HER2 (human epidermal growth factor receptor 2) positivity. FNA‐positive patients were more likely to undergo mastectomy and to receive chemotherapy. Kaplan‐Meier analysis showed that positive FNA is associated with poor prognosis, both with respect to disease‐free survival (89% nonpositive versus 73% positive at 5 years, P