ArticleWorld journal of surgical oncology2025
Intraoperative ultrasound-guided wire(IOUS-wire) localization biopsy versus preoperative fine needle aspiration cytology(FNAC) for early breast cancer with clinically positive nodes, a retrospective cohort study.
Article in World journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe false-negative rate (FNR) of fine needle aspiration (FNA) for clinically positive (suspicious) lymph nodes (LNs) remains excessively high.
methodsWe compared the feasibility and diagnostic efficiency of using a novel procedure to FNA for the assessment of clinically positive nodes in patients with early breast cancer. Between 1 January 2015 and 30 September 2023, 198 consecutive patients who consented to undergo axillary biopsy were referred to either the intraoperative ultrasound-guided wire localization group (IOUS-wire) or the ultrasound-guided fine needle aspiration group (US-FNAC). The primary endpoint was the false-negative rate (FNR) and accuracy rates of the two methods. One hundred patients were in the IOUS-wire group, whereas the other 98 patients were in the US-FNAC group.
resultsThe FNR of clinically positive lymph node biopsies was lower in the IOUS-wire localization group than in the US-FNAC group (16.1% versus 87.5%, p < 0.001). Among the 32 successfully identified metastatic lymph nodes, 26 (81.3%) were detected in the IOUS-wire group. In the US-FNAC group, 42 additional lymph node metastases were identified via SLNB among patients initially classified as FNAC-negative. The accuracy rates for IOUS-wire and US-FNAC were 95% and 57.1%, respectively (p < 0.001). No significant differences were observed in complications or median SLNs harvested between groups.
conclusionIOUS-wire localization with frozen sections demonstrated superior diagnostic performance compared to preoperative US-FNAC in patients with clinically node-positive early breast cancer. This novel method should be further pursued as a potential biopsy method for evaluating axillary node status, particularly in settings where rapid intraoperative decision-making is prioritized.
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