Diagnostic accuracy of core biopsy in patients presenting with axillary lymphadenopathy and suspected non-breast malignancy
| Autor: | Nicola Mason, Jennifer Royds, Wilma Jack, J Michael Dixon, Dominique Twelves, Monisha Edirisooriya, Fiona Scott, Arran K Turnbull |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Breast Neoplasms Malignancy 030218 nuclear medicine & medical imaging Metastatic carcinoma Diagnosis Differential 03 medical and health sciences 0302 clinical medicine False positive paradox Axillary Lymphadenopathy medicine Humans Pathological Lymph node Aged Retrospective Studies business.industry General Medicine Middle Aged medicine.disease Lymphoma Axilla medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Lymphatic Metastasis Surgery Female Radiology Biopsy Large-Core Needle business |
| Zdroj: | European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 47(7) |
| ISSN: | 1532-2157 |
| Popis: | Introduction Excision biopsy has been the investigation of choice for patients presenting with pathological axillary lymphadenopathy without a breast abnormality. Core biopsy of nodes can provide sufficient tissue for diagnosis and has advantages in terms of morbidity and speed of diagnosis. This study evaluates the diagnostic accuracy of core biopsy in patients presenting with axillary lymphadenopathy. Methods Between 2009 and 2019, 165 patients referred to the Edinburgh Breast Unit had a total of 179 axillary lymph node core biopsies. Results 152 (92%) of the 165 initial core biopsies were deemed to contain adequate nodal tissue. Core biopsy correctly established malignancy in 75 of the 78 patients with haematological malignancy (96%) and in all 28 patients with metastatic carcinoma (100%) and correctly diagnosed benign changes in 49 of 57 (86%) patients with benign conditions. There were no false positives and no false negatives. In 67 (85.9%) of the 78 patients with haematological malignancy there was sufficient material in the first core biopsy to allow the pathologist to make an actionable diagnosis and not ask for more tissue sampling prior to treatment. There were no complications of core biopsy. On follow up, none of the patients with benign cores has been shown to have malignancy in the axilla and none with lymphoma had their initial disease incorrectly classified. Conclusions This study shows that core biopsy is now the investigation of choice for patients presenting with axillary lymphadenopathy even in those suspected as having lymphoma. |
| Databáze: | OpenAIRE |
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