{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T15:03:55Z","timestamp":1770822235628,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2011,3,22]],"date-time":"2011-03-22T00:00:00Z","timestamp":1300752000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2011,10,25]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>Image\u2010guided fine\u2010needle aspiration (FNA) studies of axillary lymph nodes (LN) to evaluate breast carcinoma have shown high specificity but variable sensitivity. The purposes of this study were to evaluate the performance of axillary LN FNA depending on clinicoradiologic findings and to document how treatment varied according to FNA results.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>The study cohort consisted of consecutive axillary LN FNA cases over a 4\u2010year period, in which subsequent treatment was known. Clinicoradiologic assessment was classified as \u201clow suspicion\u201d or \u201chigh suspicion\u201d and cytopathologic findings as \u201cpositive,\u201d \u201cnegative,\u201d or \u201cindeterminate\u201d. The test performance for each, using surgical pathology outcome as the \u201cgold standard,\u201d was calculated. The impact of axillary LN FNA on subsequent management decisions was analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>Of the 163 cases, axillary FNA was positive in 94 of 163 (58%), negative in 55 of 163 (34%), and atypical\/nondiagnostic in 14 of 163 (8%). A clinicoradiologic assessment of \u201chigh suspicion\u201d had a positive predictive value (PPV) of 88%, whereas a \u201clow suspicion\u201d assessment had a negative predictive value (NPV) of only 68%. In contrast, the PPV and NPV of axillary LN FNA were 98.7% and 81.8%, respectively. Whereas all of the FNA\u2010nonpositive cases were managed surgically, surgery was deferred in 26 of 94 of the FNA\u2010positive cases, including 11 cases of neoadjuvant treatment. Most of the remaining (65 of 68) FNA\u2010positive patients were spared sentinel lymph node biopsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Image\u2010guided LN FNA is highly sensitive and specific for lymph node involvement by breast carcinoma and plays a role both in sparing sentinel lymph node biopsy and in triaging cases for systemic therapy. Cancer (Cancer Cytopathol) 2011. \u00a9 2011 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.20152","type":"journal-article","created":{"date-parts":[[2011,3,22]],"date-time":"2011-03-22T11:49:17Z","timestamp":1300794557000},"page":"328-334","source":"Crossref","is-referenced-by-count":24,"title":["The evolving role of axillary lymph node fine\u2010needle aspiration in the management of carcinoma of the breast"],"prefix":"10.1002","volume":"119","author":[{"given":"Martin C.","family":"Chang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pavel","family":"Crystal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terence J.","family":"Colgan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,3,22]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.157.1.1646562"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.20055"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002689900227"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0096(199702)25:2<53::AID-JCU1>3.0.CO;2-I"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2168.1999.01243.x"},{"key":"e_1_2_6_7_2","first-page":"240","article-title":"Accuracy of ultrasound and clinical examination of the diagnosis of axillary lymph node metastasis in breast cancer","volume":"17","author":"de Freitas R","year":"1991","journal-title":"Eur J Surg Oncol"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00833382"},{"key":"e_1_2_6_9_2","first-page":"1275","article-title":"Little extra information with ultrasound studies of the axillary glands in patients with breast carcinoma [in Dutch]","volume":"135","author":"Perre CI","year":"1991","journal-title":"Ned Tijdschr Geneeskd"},{"key":"e_1_2_6_10_2","first-page":"139","article-title":"Taylor I. Ultrasound detection of axillary lymph node metastasis in breast cancer","volume":"15","author":"Tate JJ","year":"1989","journal-title":"Eur J Surg Oncol"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.7863\/jum.1989.8.3.115"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.158.2.3510440"},{"key":"e_1_2_6_13_2","first-page":"15","article-title":"Ultrasonographic detection of metastatic axillary lymph nodes in breast cancer","volume":"79","author":"Mustonen P","year":"1990","journal-title":"Ann Chir Gynaecol"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-009-0421-9"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(02)00501-4"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2005.01.024"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10786"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-006-9355-0"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2007.07.198"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4741.2010.00952.x"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2007.02.004"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23344"},{"key":"e_1_2_6_23_2","volume-title":"SEER Cancer Statistics Review, 1975\u20102006","year":"2008"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/dc.2840090623"},{"key":"e_1_2_6_25_2","article-title":"Core needle biopsy versus fine needle aspiration biopsy in breast\u2014a historical perspective and opportunities in the modern era [Published online ahead of print October 14, 2010]","author":"Nassar A","journal-title":"Diagn Cytopathol"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1986.4.12.1765"},{"key":"e_1_2_6_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12094-010-0538-0"}],"container-title":["Cancer Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncy.20152","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncy.20152","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T08:50:34Z","timestamp":1760259034000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncy.20152"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,3,22]]},"references-count":26,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2011,10,25]]}},"alternative-id":["10.1002\/cncy.20152"],"URL":"https:\/\/doi.org\/10.1002\/cncy.20152","archive":["Portico"],"relation":{},"ISSN":["1934-662X","1934-6638"],"issn-type":[{"value":"1934-662X","type":"print"},{"value":"1934-6638","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,3,22]]}}}