Axillary fine needle aspiration cytology is a sensitive and highly specific technique for the detection of axillary lymph node metastasis: a meta-analysis and systematic review.

BACKGROUND: Fine needle aspiration cytology (FNAC) of axillary lymphadenopathy is a helpful tool in the pre-operative diagnosis of breast cancer patients with axillary lymphadenopathy. To date, no published meta-analysis or systematic review has been performed to assess its overall value. We therefore conducted a meta-analysis to establish the overall diagnostic value of FNAC for axillary lymph node metastasis. METHODS: After a review and quality assessment of 31 studies, published either in Chinese or English, the sensitivity, specificity and other measurements of accuracy of FNAC of axillary lymphadenopathy were pooled using random-effects models. A summary of the receiver-operating characteristic curves was used to summarize overall accuracy. RESULTS: We provided the following estimated values for FNAC in the diagnosis of axillary lymph node metastasis: sensitivity, 0.63 [95% confidence interval (CI), 0.61-0.65]; specificity, 0.99 (95% CI, 0.99-0.99); positive likelihood ratio, 26.52 (95% CI, 18.42-38.18); negative likelihood ratio, 0.34 (95% CI, 0.29-0.40); diagnostic odds ratio, 76.73 (95% CI, 51.98-113.28). CONCLUSIONS: FNAC has adequate sensitivity and high specificity in the diagnosis of axillary lymph node metastasis. A positive axillary FNA result could potentially alter disease management.

[Efficacy observation of (125)I seed implantation therapy for locoregional recurrent and metastatic breast cancer].

OBJECTIVE: To assess the efficacy and side effects of (125)I seed implantation for locoregional recurrent and metastatic breast cancer, and to discuss its role in the comprehensive therapy of breast cancer. METHODS: Forty-three patients with locoregional recurrent or metastatic breast cancer were included in this study. They received (125)I seed implantation and were followed up to evaluate the efficacy and adverse reactions of the treatment. RESULTS: Among 54 lesions in the 43 cases, there were complete response (CR) in 39, partial response (PR) in 13, stable disease (SD) in 2 patients, with a response rate of 96.3%. All 17 cases with local pain achieved pain relief. With a median follow up of 36 months (range 14 to 60 months), the 1-, 3-, and 5-year local control rate was 85.2%, 53.7% and 1.9%, and the 1-, 3-, and 5-year survival rate was 95.3%, 67.4% and 37.2%, respectively. No serious radiotherapy side effect was observed. CONCLUSION: In patients with unresectable locoregional recurrent or metastatic breast cancer, (125)I seed implantation shows proved efficacy and few complications, and can be an important treatment option.