A multi-center retrospective analysis of ultrasound-guided fine needle aspiration biopsy for detecting additional positive axillary node metastasis in early breast cancer
Abstract This study evaluates the effectiveness of ultrasound-guided fine needle aspiration biopsy (US-FNAB) in assessing additional positive axillary lymph node (ALN) metastasis following sentinel lymph node biopsy (SLNB) in clinically ALN-negative or N1 cases, aiming to refine patient management....
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Nature Portfolio
2025-05-01
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| Online Access: | https://doi.org/10.1038/s41598-025-01353-z |
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| author | Youjia Li Mengru Dong Shengyu Liao Yu Jiang Yingjie Niu Yiqin Huang Wei Fu Debo Chen Zhipeng Hong |
| author_facet | Youjia Li Mengru Dong Shengyu Liao Yu Jiang Yingjie Niu Yiqin Huang Wei Fu Debo Chen Zhipeng Hong |
| author_sort | Youjia Li |
| collection | DOAJ |
| description | Abstract This study evaluates the effectiveness of ultrasound-guided fine needle aspiration biopsy (US-FNAB) in assessing additional positive axillary lymph node (ALN) metastasis following sentinel lymph node biopsy (SLNB) in clinically ALN-negative or N1 cases, aiming to refine patient management. A multi-center, retrospective analysis included 7617 patients with cT1-2 and cN0-1, who underwent US-FNAB for ALN and proceeding to SLNB or axillary lymph node dissection (ALND). Metastatic patterns were assessed, particularly focusing on correlations with positive FNAB results and additional ALN metastasis found during ALND, with statistical significance evaluated. Of those undergoing SLNB, 97.5% exhibited macrometastasis. In the SLNB-only group, 2.4% had 3 and more than 3 positive lymph node, compared to 19.2% in the SLNB & ALND group (P < 0.01). Among ALND patients, 63.3% had positive nodes, significantly higher in those with positive FNAB (91.9% vs. 22.8%, P < 0.001). Additionally, 40.9% were found to have additional positive ALNs in patients who underwent ALND following positive SLNB, with rates significantly higher in those with positive FNAB (60.3% vs. 35.4%, P < 0.001). LVI positivity, pT2-3, SLNR > 50% and positive FNAB were independent predictors of additional ALN metastasis in patients undergoing ALND after positive SLNB (P < 0.05). The proportion of additional positivity escalated with the number of positive SLNs. US-FNAB significantly improves the detection of additional ALN metastasis, guiding more effective strategy for ALN surgical decision-making. Our findings support the incorporation of US-FNAB into clinical practice to improve patient stratification and optimize treatment outcomes in early-stage breast cancer management. |
| format | Article |
| id | doaj-art-1c8f72e3734445f0a8d1581614ffce97 |
| institution | DOAJ |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-1c8f72e3734445f0a8d1581614ffce972025-08-20T03:22:02ZengNature PortfolioScientific Reports2045-23222025-05-0115111010.1038/s41598-025-01353-zA multi-center retrospective analysis of ultrasound-guided fine needle aspiration biopsy for detecting additional positive axillary node metastasis in early breast cancerYoujia Li0Mengru Dong1Shengyu Liao2Yu Jiang3Yingjie Niu4Yiqin Huang5Wei Fu6Debo Chen7Zhipeng Hong8Department of Ultrasound, Affiliated Quanzhou First Hospital of Fujian Medical UniversityStandardization Training Office, Affiliated Quanzhou First Hospital of Fujian Medical UniversityDepartment of Breast Surgery, Bazhong Central HospitalThe School of Clinical Medicine, Fujian Medical UniversityThe School of Clinical Medicine, Fujian Medical UniversityThe School of Clinical Medicine, Fujian Medical UniversityThe School of Clinical Medicine, Fujian Medical UniversityThe School of Clinical Medicine, Fujian Medical UniversityThe School of Clinical Medicine, Fujian Medical UniversityAbstract This study evaluates the effectiveness of ultrasound-guided fine needle aspiration biopsy (US-FNAB) in assessing additional positive axillary lymph node (ALN) metastasis following sentinel lymph node biopsy (SLNB) in clinically ALN-negative or N1 cases, aiming to refine patient management. A multi-center, retrospective analysis included 7617 patients with cT1-2 and cN0-1, who underwent US-FNAB for ALN and proceeding to SLNB or axillary lymph node dissection (ALND). Metastatic patterns were assessed, particularly focusing on correlations with positive FNAB results and additional ALN metastasis found during ALND, with statistical significance evaluated. Of those undergoing SLNB, 97.5% exhibited macrometastasis. In the SLNB-only group, 2.4% had 3 and more than 3 positive lymph node, compared to 19.2% in the SLNB & ALND group (P < 0.01). Among ALND patients, 63.3% had positive nodes, significantly higher in those with positive FNAB (91.9% vs. 22.8%, P < 0.001). Additionally, 40.9% were found to have additional positive ALNs in patients who underwent ALND following positive SLNB, with rates significantly higher in those with positive FNAB (60.3% vs. 35.4%, P < 0.001). LVI positivity, pT2-3, SLNR > 50% and positive FNAB were independent predictors of additional ALN metastasis in patients undergoing ALND after positive SLNB (P < 0.05). The proportion of additional positivity escalated with the number of positive SLNs. US-FNAB significantly improves the detection of additional ALN metastasis, guiding more effective strategy for ALN surgical decision-making. Our findings support the incorporation of US-FNAB into clinical practice to improve patient stratification and optimize treatment outcomes in early-stage breast cancer management.https://doi.org/10.1038/s41598-025-01353-zUltrasound-guidedFine needle aspiration biopsySentinel lymph node biopsyAxillary lymph node dissectionEarly breast cancer |
| spellingShingle | Youjia Li Mengru Dong Shengyu Liao Yu Jiang Yingjie Niu Yiqin Huang Wei Fu Debo Chen Zhipeng Hong A multi-center retrospective analysis of ultrasound-guided fine needle aspiration biopsy for detecting additional positive axillary node metastasis in early breast cancer Scientific Reports Ultrasound-guided Fine needle aspiration biopsy Sentinel lymph node biopsy Axillary lymph node dissection Early breast cancer |
| title | A multi-center retrospective analysis of ultrasound-guided fine needle aspiration biopsy for detecting additional positive axillary node metastasis in early breast cancer |
| title_full | A multi-center retrospective analysis of ultrasound-guided fine needle aspiration biopsy for detecting additional positive axillary node metastasis in early breast cancer |
| title_fullStr | A multi-center retrospective analysis of ultrasound-guided fine needle aspiration biopsy for detecting additional positive axillary node metastasis in early breast cancer |
| title_full_unstemmed | A multi-center retrospective analysis of ultrasound-guided fine needle aspiration biopsy for detecting additional positive axillary node metastasis in early breast cancer |
| title_short | A multi-center retrospective analysis of ultrasound-guided fine needle aspiration biopsy for detecting additional positive axillary node metastasis in early breast cancer |
| title_sort | multi center retrospective analysis of ultrasound guided fine needle aspiration biopsy for detecting additional positive axillary node metastasis in early breast cancer |
| topic | Ultrasound-guided Fine needle aspiration biopsy Sentinel lymph node biopsy Axillary lymph node dissection Early breast cancer |
| url | https://doi.org/10.1038/s41598-025-01353-z |
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