Role of ultrasound-guided core needle biopsy of axillary lymph nodes in the initial staging of breast carcinoma

To evaluate the role of US-guided core biopsy in detection of metastatic axillary lymph nodes in preoperative staging of breast cancer. US-guided core biopsy of suspicious axillary lymph nodes was performed in 39 patients with breast cancer. Biopsy results were compared to the axillary dissection results. Sensitivity, specificity and accuracy of the core biopsy in the detection of malignancy were calculated. Thirty-nine patients were assessed with biopsy; 30 patients were found to have metastatic carcinoma and nine had benign reactive hyperplasia. In 26 of 30 cases with biopsy-proven metastatic disease, there were malignant lymph nodes detected at axillary dissection. Four cases that had positive biopsy results and negative axillary dissection were accepted as complete response to chemotherapy. In three of nine cases with benign reactive hyperplasia, axillary dissection revealed metastatic disease. No significant complications were observed other than pain responding to analgesics. The sensitivity, specificity and accuracy of core biopsy in detection of malignancy were 90%, 100% and 92%, respectively. The results were statistically significant ( p < 0.001). Ultrasonographically detected lymph nodes can be easily assessed by US-guided biopsy. Core biopsy is a reliable and easily performed method without significant complications.