Preoperative assessment of the axilla by surgeon performed ultrasound and cytology in XXXX with @entity0 .

@entity1 @entity0 @entity1600 @entity2286 @entity3
BACKGROUND: Preoperative evaluation of the axilla, an important prognostic determinant for @entity1 with @entity0 , is achieved by non- or minimally invasive methods to avoid the potential hazards of operative intervention. The aim of this study was to determine statistical power of axillary ultrasound (US) and US-guided fine needle aspiration cytology (FNAC) for evaluating axillary status. METHODS: Axillary lymph nodes were imaged for malignant involvement by high resolution US in 93 @entity0 @entity1 with clinically negative axilla. Cytological samples were obtained by US-guided FNAC from image-suspicious lymph nodes. Cytology-positive @entity1 directly underwent @entity1600 ( @entity1600 ). @entity1 with US and/or cytology-negative axilla underwent @entity1600 ( @entity1600 ). Using statistical analysis, US findings and US combined with FNAC were compared with @entity1600 and final pathology to measure performance. RESULTS: US was suspicious for @entity3 in 38 @entity1 (41%), of whom 16 (42%) were cytology-positive. Axilla was positive in 36/93 @entity1 (38.7%). Sixteen @entity1 with positive FNAC directly underwent @entity1600 . @entity1600 and/or final pathology was positive in 13/55 @entity1 (23.7%) with negative US (false negative of US) and in 7/22 @entity1 (31.8%) with positive US but negative cytology (false negative of FNAC). @entity1600 and/or final pathology was negative in 15/38 @entity1 (39.5%) with positive US (false positive of US). Sensitivity, specificity, accuracy, positive predictive value ( @entity2286 ) and negative predictive value (NPV) of US alone were 63.8%, 73.6%, 69.8%, 60.5% and 76.3%, respectively, and 69.6%,100%, 81.6%, 100% and 68.1%, respectively, for US combined with FNAC. CONCLUSION: Statistical measures of the US alone did not achieve a satisfactory value for excluding operative biopsy. US-negative and US-positive but cytology-negative cases still require @entity1600 for accurate evaluation of axillary status. On the other hand, US-guided positive cytology can obviate @entity1600 proceeding directly to @entity1600 and avoiding frozen section of sentinel node(s).
