IMPORTANCE OF ULTRASONIC GUIDED FINE-NEEDLE ASPIRATION CYTOLOGY IN THE ASSESSMENT OF AXILLARY NODE STATUS AMONG PATIENTS WITH BREAST CANCER

Aim: The standard axillary treatment for breast cancer patient without clinical evidence of axillary nodes is SLNB and if positive leads to axillary clearance but this has some inherent pitfalls. The main objective of this study was to evaluate the diagnostic accuracy and utility of ultrasound guided FNAC in preoperative assessment of axillary lymph nodes and selecting those who should and should not be offered SLNB in breast cancer patients. Place and Duration: In the Surgical Unit II of Nishter Hospital Multan for one year duration from January 2019 to January 2020. Methods: All prospective or screened breast cancer patients with clinically negative armpit were included in this prospective study. Of the 131 patients, 67 have negative axillary ultrasound scans, while 64 patients with suspicious nodes had FNAC and 27 were positive for malignant tumors. Results: In recent histopathological examination, positive nodes were found in 57 patients: 42/64 (66%) of suspected nodes and Negative axillary ultrasound 15/67 (22%). The U/S has sensitivity of 73% and specificity of 70% while U/S guided FNAC has sensitivity of 64% but specificity of 100%. It correctly diagnosed 27/57(47%) positive nodes and 21% of all patients where axillary clearance was performed directly without SLNB. Conclusion: It is concluded that axillary ultrasound and FNAC are a useful diagnostic tool that will add preoperative information on the status of the axillary node, minimize the false negative factor as well as will save cost and time by avoiding SLNB in nearly a quarter of patients. Keywords: Axillary lymph nodes, Ultrasound guided FNAC, breast cancer, ultrasound examination