Can Breast Cancer Biopsy Influence Sentinel Lymph Node Status?

Area of Science:

• Oncology
• Radiology
• Pathology

Background:

• Sentinel lymph node (SLN) status is crucial for breast cancer (BC) staging and treatment.
• Ultrasound-guided core needle biopsy (US-CNB) is a common method for diagnosing breast lesions.
• The influence of needle size during US-CNB on SLN metastasis has not been extensively studied.

Purpose of the Study:

• To investigate whether needle size used in US-CNB affects the occurrence of metastasis in axillary SLNs in breast cancer patients.
• To determine if larger gauge needles in US-CNB are associated with different SLN metastasis rates compared to smaller needles.

Main Methods:

• Retrospective review of 377 breast cancer cases undergoing US-CNB and SLN dissection between January 2011 and January 2015.
• Patients were categorized into two groups based on needle size: 14-gauge versus 16- or 18-gauge.
• SLN metastasis was classified using the AJCC TNM staging system (macrometastases, micrometastases, isolated tumor cells, or negative).

Main Results:

• A total of 377 breast cancer cases were analyzed; 268 used 14-gauge needles and 109 used 16- or 18-gauge needles.
• The negative SLN rate was significantly higher with larger needles (14-gauge) compared to smaller needles (16- or 18-gauge) (P = .002).
• The macrometastasis rate was 17% for the 14-gauge group and 3% for the 16- and 18-gauge groups.

Conclusions:

• The size of the needle used in US-CNB does not appear to influence sentinel lymph node metastasis in breast cancer.
• Preoperative breast biopsy using US-CNB is a safe and reliable procedure for diagnosing malignant breast lesions.
• These findings support the continued use of US-CNB regardless of needle size for accurate breast cancer diagnosis.