Breast cancer patients with positive ultrasound findings and a positive ultrasound-guided axillary node biopsy (USNB) should then receive axillary dissection, according to a study presented at the American Roentgen Ray Society (ARRS) meeting.
In a study comparing 199 patients with a positive USNB to 434 patients with a positive sentinel lymph node biopsy, researchers from the University of Pittsburgh Medical Center found that about 50% of patients with a positive USNB had substantial lymph node involvement, compared with 16% of patients with a positive sentinel node biopsy.
Since the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial suggested that axillary lymph node dissection may be omitted in select patients with a positive sentinel lymph node biopsy, many institutions no longer routinely perform USNBs of suspicious axillary nodes in breast cancer patients who are candidates for sentinel node biopsy alone.
However, the results of the University of Pittsburgh study indicate that patients with a positive ultrasound-guided axillary node biopsy represent a distinct population, and the Z0011 trial should probably not be extrapolated to this group, said co-author Dr. Lee Spangler.
