ArticleGland surgery2026
Core needle biopsy washout biomarkers combined with ultrasound for preoperative axillary risk stratification in breast cancer: a retrospective nomogram study with temporal validation.
Article in Gland surgery, 2026. 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
Background: Preoperative assessment of axillary lymph node (ALN) involvement informs breast cancer surgical planning. Axillary ultrasound (US) is routine but may miss occult disease. We evaluated whether vascular endothelial growth factor-C (VEGF-C) and cytokeratin 19 (CK19) in primary-tumor core needle biopsy (CNB) washout fluid improved US-based risk assessment. Methods: This single-center retrospective temporal-validation study screened 493 women with primary breast cancer who underwent preoperative axillary US, primary-lesion CNB, and postoperative nodal pathology from June 2023 to July 2025. Eligible cases were split by calendar time into development and temporal-validation cohorts. CNB washout VEGF-C and CK19 were measured by enzyme-linked immunosorbent assay (ELISA). A four-variable logistic model was fitted in development and applied unchanged to temporal validation. Results: The eligible analysis set included 380 patients: 278 in development and 102 in temporal validation. Pathological ALN metastasis was present in 114 (41.0%) and 42 (41.2%) patients, respectively. The model included tumor size, positive axillary US status, log Conclusions: CNB washout VEGF-C and CK19 complemented axillary US and tumor size for preoperative ALN risk stratification and retained moderate discrimination in later same-center patients. Multicenter external validation is required before clinical use.
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