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A four node axillary sampling trial on breast cancer patients
Kanji Tanaka1, Daigo Yamamoto, Sayaka Kanematsu
1Department of Surgery, Kansai Medical University, 10-15, Fumizono, Moriguchi, Osaka 570-8507, Japan. tanakkan@takii.kmu.ac.jp
Breast (Edinburgh, Scotland)
|August 3, 2005
Summary
Four node axillary sampling (4NAS) shows high accuracy in staging early breast cancer, comparable to axillary node clearance (ANC). This minimally invasive technique offers a reliable alternative for assessing axillary lymph nodes.
Area of Science:
- Oncology
- Surgical Oncology
- Pathology
Background:
- Axillary lymph node management in early breast cancer is debated.
- Established procedures include axillary node clearance (ANC) and sentinel node biopsy.
- Four node axillary sampling (4NAS) is an alternative approach.
Purpose of the Study:
- To prospectively evaluate the accuracy of 4NAS compared to ANC.
- To determine the correlation between 4NAS and ANC in staging early breast cancer.
Main Methods:
- Prospective study of 237 patients with stage I and II primary breast cancer.
- Comparison of diagnostic values between 4NAS and ANC.
- Analysis of sensitivity, specificity, overall accuracy, and false negative rates.
Main Results:
- 4NAS demonstrated high sensitivity (92.9% stage I, 93.8% stage II), specificity (100%), and overall accuracy (98.5% stage I, 98.3% stage II).
- Low false negative rates were observed: 7.1% (stage I), 6.3% (stage II), and 6.5% overall.
- False negatives were associated with micrometastases in N0 cases.
Conclusions:
- 4NAS is a highly accurate method for staging axillary lymph nodes in early breast cancer.
- 4NAS may serve as an effective alternative to ANC.
- Further investigation into false negatives due to micrometastases is warranted.