{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T10:22:32Z","timestamp":1760782952945},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2007,4,27]],"date-time":"2007-04-27T00:00:00Z","timestamp":1177632000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2007,4,27]],"date-time":"2007-04-27T00:00:00Z","timestamp":1177632000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2007,4,27]],"date-time":"2007-04-27T00:00:00Z","timestamp":1177632000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2007,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We evaluated the effectiveness and the cost of axillary staging in breast cancer patients by ultrasound\u2010guided fine\u2010needle aspiration cytology (US\u2010FNAC), sentinel node biopsy (SNB), and frozen sections of the sentinel node to achieve the target of the highest number of immediate axillary dissections. From January 2003 through October 2005, a total of 404 consecutive eligible breast cancer patients underwent US\u2010FNAC of suspicious axillary lymph nodes. If tumor cells were found, immediate axillary dissection was proposed (33% of node\u2010positive cases). If US or cytology was negative, SNB was performed. Frozen sections of the sentinel node allowed immediate axillary dissection in 31% of node\u2010positive cases. The remaining 36% underwent delayed axillary dissection. We compared our policy with clinical evaluation of the axilla, showing better specificity of US\u2010FNAC, the cost balanced by a 12% reduction of SNBs, and a marked reduction of unnecessary axillary dissections resulting from false\u2010positive clinical staging. Moreover, the comparison between our policy and permanent histology of the sentinel node showed an 8% cost saving, mainly associated with the immediate axillary dissections. US\u2010FNAC of axillary lymph nodes in breast cancer patients reliably predicts the presence of metastases and therefore refers a significant number of patients to the appropriate surgical treatment, avoiding an SNB. As cost saving to the health care system in our study is mainly related to one\u2010step axillary surgery, US\u2010FNAC of axillary lymph nodes and frozen section of the sentinel node generate significant cost saving for patients who have metastatic nodes.<\/jats:p>","DOI":"10.1007\/s00268-007-9009-3","type":"journal-article","created":{"date-parts":[[2007,4,26]],"date-time":"2007-04-26T19:51:01Z","timestamp":1177617061000},"page":"1157-1165","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Cost\/Accuracy Ratio Analysis in Breast Cancer Patients Undergoing Ultrasound\u2010Guided Fine\u2010Needle Aspiration Cytology, Sentinel Node Biopsy, and Frozen Section of Node"],"prefix":"10.1002","volume":"31","author":[{"given":"Franco","family":"Genta","sequence":"first","affiliation":[{"name":"Ginteam, Mini\u2010Invasive Gynaecological and Breast Surgery Unit Evangelical Hospital ASL 1 Torino Italy"},{"name":"Strada Rebaude 126 10024 Torino Moncalieri Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugenio","family":"Zanon","sequence":"additional","affiliation":[{"name":"Breast Radiology Unit Evangelical Hospital ASL 1 Torino Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Camanni","sequence":"additional","affiliation":[{"name":"Ginteam, Mini\u2010Invasive Gynaecological and Breast Surgery Unit Evangelical Hospital ASL 1 Torino Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Deltetto","sequence":"additional","affiliation":[{"name":"Ginteam, Mini\u2010Invasive Gynaecological and Breast Surgery Unit Evangelical Hospital ASL 1 Torino Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Drogo","sequence":"additional","affiliation":[{"name":"Breast Radiology Unit Evangelical Hospital ASL 1 Torino Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosanna","family":"Gallo","sequence":"additional","affiliation":[{"name":"Breast Radiology Unit Evangelical Hospital ASL 1 Torino Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carla","family":"Gilardi","sequence":"additional","affiliation":[{"name":"Breast Radiology Unit Evangelical Hospital ASL 1 Torino Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2007,4,27]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/jso.20343"},{"key":"e_1_2_7_3_2","first-page":"1","article-title":"Post\u2010operative arm morbidity and quality of life. 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