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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
Author(s) -
Yu Y.H.,
Mo Q.G.,
Zhu X.,
Gao L.Q.,
Liang C.,
Huang Z.,
Qin Q.H.,
Wei W.,
Jiang Y.,
Bu K.P.,
Wei C.Y.
Publication year - 2016
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/cyt.12224
Subject(s) - medicine , diagnostic odds ratio , meta analysis , odds ratio , fine needle aspiration , radiology , likelihood ratios in diagnostic testing , axillary lymph nodes , confidence interval , metastasis , axillary lymphadenopathy , breast cancer , axilla , lymph node , gold standard (test) , fine needle aspiration cytology , receiver operating characteristic , biopsy , cancer , pathology
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.