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  • Poster presentation
  • Open Access

PB.51: Axillary lymph node ultrasound and fine needle aspiration in preoperative staging of breast cancer: re-audit

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Breast Cancer Research201315 (Suppl 1) :P51

  • Published:


  • Fine Needle Aspiration
  • Repeat Biopsy
  • Axillary Staging
  • Axillary Ultrasound
  • Combine Sensitivity


Axillary ultrasound and fine needle aspiration (FNA) are used to triage breast cancer patients to appropriate axillary surgery. We present a complete audit cycle. Departmental guidelines were changed to include repeat biopsy in cases with suspicious ultrasound/negative FNA and for patients with inconclusive FNA results between audit periods one and two.


Retrospective analysis of multidisciplinary meeting and pathology records of all breast cancer patients operated upon in our Trust between January and June 2010, and then between January and December 2012, was reviewed. Descriptive statistics were performed.


Initial audit findings included 125 female patients, with overall combined sensitivity and specificity of ultrasound/FNA being 64% (21/33) and 100% (92/92) respectively. Included in the re-audit were 378 female patients, all underwent axillary ultrasound. Of these, 50.3% (190/378) patients underwent an FNA with 18.4% (35/190) having repeat FNA or core biopsy for inconclusive results. Of the repeat biopsies, 80% (28/35) were benign and 20% (7/35) were malignant. Ultrasound sensitivity was 78.9% (86/109). Sensitivity of FNA/biopsy was 82.6% (71/86). Overall combined sensitivity of ultrasound/FNA was 62.2% (74/119). Ultrasound specificity was 62.1% (167/269). Specificity of FNA was 97.1% (101/104). Overall combined specificity of ultrasound/FNA was 98.9% (266/269).


Performing a repeat FNA/biopsy on inconclusive cases proved valuable in that 80% patients were spared from surgical morbidity. However, overall sensitivity of preoperative axillary staging has not significantly changed between cycles following resampling. Further audit, analysis and guideline review is needed to ensure optimal patient care.

Authors’ Affiliations

South Tyneside Hospital, South Shields, UK
Queen Elizabeth Hospital, Gateshead, UK


© Kazi et al.; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.