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Immune Profiling the Axilla with Fine Needle Aspiration Is Feasible to Risk-Stratify Breast Cancer.
Jasmine A Gore1, Amy M Llewellyn1,2, Chuen Y R Lam2
1Translational Pathology, The Rayne Institute, Comprehensive Cancer Centre, King's College London, London SE5 9NU, UK.
Cancers
|January 28, 2026
Summary
Fine needle aspiration (FNA) of axillary lymph nodes (ALNs) in breast cancer (BC) can identify immune cell profiles. This method may help risk-stratify BC patients by reflecting tumor burden, reducing the need for invasive surgery.
Area of Science:
- Oncology
- Immunology
- Surgical Pathology
Background:
- Axillary lymph node (ALN) metastasis is a key prognostic factor in breast cancer (BC).
- Current axillary staging methods carry morbidity; less invasive risk-stratification techniques are needed.
- Axillary lymph node fine needle aspiration (FNA) samples contain immune cells alongside potential cancer cells.
Purpose of the Study:
- To assess the feasibility of using FNA to immunophenotype leukocytes from patient-derived ALNs.
- To determine if ALN immune cell profiles obtained via FNA correlate with breast cancer axillary tumor burden.
- To explore FNA's potential for non-invasive BC patient risk-stratification.
Main Methods:
- Fine needle aspiration (FNA) was performed on axillary lymph nodes (ALNs) from breast cancer (BC) patients.
- Collected cells were analyzed using flow cytometry for comprehensive immunophenotyping.
- Immune cell profiles were compared between patients with varying metastatic axillary lymph node burdens.
Main Results:
- FNA successfully acquired sufficient leukocytes for detailed immunophenotyping of ALN immune cells.
- Immune cell profiles from FNA reflected differences in axillary tumor burden, distinguishing patients with ≤1 vs. ≥2 metastatic ALNs.
- Specific T-cell subsets, NK cells, and pDCs showed distinct patterns related to metastatic status, offering insights beyond traditional histology.
Conclusions:
- Fine needle aspiration (FNA) is a feasible method for sampling leukocytes from breast cancer patient axillary lymph nodes (ALNs).
- FNA-derived immune cell profiles correlate with axillary tumor burden, indicating potential for non-invasive risk stratification.
- This technique may offer a less invasive approach to managing breast cancer patients in the future.
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