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The following is a summary of “Examining the False-Negative Rate of a Negative Axillary Node Ultrasound-Guided Core Needle Biopsy in Breast Cancer Patients Undergoing Upfront Surgery,” published in the October 2024 issue of Surgery by Rogers et al.  

Axillary assessment is crucial in breast cancer management to determine the appropriate surgical approach or the need for neoadjuvant chemotherapy (NAC).  

Researchers conducted a retrospective study to examine the false-negative rate (FNR) of axillary-node ultrasound-guided core needle biopsy (US-CNBx) in patients with breast cancer undergoing upfront surgery.  

They included patients with benign findings from US-CNBx who underwent upfront surgery between 2010 and 2020 (n=95). Statistical analyses included t-tests and chi-squared tests (P=0.03).  

The results showed that among the 95 axillae, 23 were patients with pN+, resulting in a FNR of 24.2%. The analysis revealed that patients with pN+ had a higher frequency of clinical T2–T3 tumors than patients with pN0 (43.5% vs. 27.8%, P=0.03). Of the 23 patients with pN+, 9 underwent breast-conserving surgery, while 14 received a mastectomy. In the breast-conserving surgery group, 7 patients had 1-2 positive nodes, and 3 patients underwent axillary lymph node dissection (ALND). Among those with mastectomies, 12 had 1-2 positive nodes, with 6 undergoing ALND.  

They concluded that the US-CNBx had a FNR of 24.2%, indicating the need for clinicians to be vigilant for occult nodal disease in patients with larger tumors when determining surgical management.  

Source: americanjournalofsurgery.com/article/S0002-9610(24)00599-3/abstract