Fine-needle aspiration biopsy of axillary lymph nodes: A reliable diagnostic tool for breast cancer staging.

BACKGROUND: Pathologic evaluation of sentinel lymph node biopsy (SLNB) samples is crucial for axillary staging in patients newly diagnosed with breast cancer. Patients with pathologic evidence of nodal metastasis scheduled for upfront surgery typically also undergo axillary lymph node dissection (ALND). Although SLNB is the gold standard method for detecting nodal metastasis, axillary lymph node fine-needle aspiration biopsy (FNAB) utility has not been thoroughly explored. METHODS: Ultrasound-guided axillary lymph node FNAB samples along with concurrent ipsilateral breast tissue samples were searched and reviewed. The control group included histologic findings of axillary dissection or intraoperative SLNB results. RESULTS: A total of 354 axillary lymph node FNAB samples with matched histology were included. Of these, 187 (52.8%) were positive for metastatic carcinoma of breast origin; 143 (40.4%) were negative for metastasis; 12 (3.4%) showed atypical cells; six (1.7%) were suspicious for metastasis; and six (1.7%) were nondiagnostic because of a lack of lymphoid tissue and malignant cells. Of the 143 negative FNAB samples, 22 (15.4%) were positive on either intraoperative SLNB or ALND. When only the positive and negative FNAB samples were accounted for (n = 330; 93.2%), overall diagnostic sensitivity and specificity were 89.4% and 99.2%, respectively. CONCLUSIONS: Although axillary SLNB is the standard procedure for detecting nodal metastasis of breast origin, axillary lymph node FNAB appears to be a suitable alternative in a significant proportion of patients. A standard SLNB should be performed in cases of negative axillary lymph node FNAB findings, particularly nodes with abnormal imaging findings.

A descriptive study of vitamin D and other nutritional factors in breast cancer patients in Saudi Arabia.

OBJECTIVES: To assess the role of serum vitamin D and other nutritional factors in women with breast cancer in Saudi. METHODS: A total of 500 women (250 patients with breast cancer and 250 controls) aged 30-60 years were recruited from King Saud Medical City and King Fahad Medical City, Riyadh, Saudi Arabia,  between May 2015 and June 2016. In this cross-sectional study, blood pressure, plasma concentrations of vitamin D, and calcium levels were evaluated. A 3-day dietary record was used to assess dietary intake. RESULTS: The mean body mass index was  31.2±7.0  kg/m2   for the breast cancer group and 30.7±7.6 kg/m2 for the control group. More than 80% of the participants had insufficient vitamin D levels (less than 75.0 nmol/L). The mean cholesterol intake was significantly (p=0.001) lower in the control group (233.1±75.1 mg) than in the breast cancer group (257.2±84.8 mg). Breast density was found to be significantly associated with vitamin D deficiency-symptoms. Severe paresthesia was also significantly associated with breast cancer. The incidence of other vitamin D deficiency-symptoms was significantly higher in the control group. CONCLUSION: Due to prevalence of vitamin D deficiency in Saudi Arabia, it is difficult to determine the relationship to breast cancer. The incidence of it is associated with old age and high cholesterol intake, and paresthesia may be a symptom of breast cancer.