Comparison of Sonography With Sonographically Guided Fine‐Needle Aspiration Biopsy and Core‐Needle Biopsy for Initial Axillary Staging of Breast Cancer

Objectives The purpose of this study was to determine the roles of sonography and sonographically guided fine‐needle aspiration biopsy and core‐needle biopsy for initial axillary staging of breast cancer. Methods Of 220 patients with breast cancer who underwent preoperative or prechemotherapy sonography for axillary staging, 52 patients who underwent sonographically guided fine‐needle aspiration biopsy and core‐needle biopsy for cortical thickening or a compressed hilum of lymph nodes on sonography were prospectively enrolled. Sonography and fine‐needle aspiration biopsy/core‐needle biopsy findings were compared with final pathologic results from sentinel lymph node biopsy or axillary lymph node dissection. Results Forty‐eight patients met the final study criteria; we excluded 4 who had received primary systemic chemotherapy and showed negative fine‐needle aspiration biopsy/core‐needle biopsy results and negative final postoperative pathologic results. The positive predictive value of axillary sonography was 54%. The sensitivity and specificity of fine‐needle aspiration biopsy were 73% and 100%, respectively, and those of core‐needle biopsy were 77% and 100%. Results did not differ significantly between sonographically guided core‐needle biopsy and fine‐needle aspiration biopsy. The complication rates of fine‐needle aspiration biopsy and core‐needle biopsy were both 4%, and fine‐needle aspiration biopsy and core‐needle biopsy cost $180 and $350, respectively. Conclusions Both sonographically guided fine‐needle aspiration biopsy and core‐needle biopsy were useful for axillary staging of breast cancer with high sensitivity. However, fine‐needle aspiration biopsy is recommended based on the advantages of low cost and minimal invasiveness.