Nonpalpable breast lesions: findings of stereotaxic needle-core biopsy and fine-needle aspiration cytology

Article Abstract:

Mammography, the X-raying of the breasts, can often detect abnormalities, but is poor at predicting whether the abnormalities are cancerous or benign. Most abnormalities are further examined by means of a biopsy, or removal of suspect tissue for microscopic examination. Traditionally, the biopsy involves a surgical procedure, which can be invasive, painful, and expensive. Less invasive biopsy procedures have been introduced, but they are often less accurate than surgical biopsy. Fine-needle aspiration biopsy (FNAB) involves inserting a needle into the suspect tissue and aspirating a sample into the needle. This technique is often hampered by the inability to get an adequate sample. A more recently introduced technique is needle-core biopsy. It involves inserting a needle in the suspect area and removing a core of tissue for examination. To further evaluate the effectiveness of the FNAB and core biopsy techniques, both were performed on 250 nonpalpable breast abnormalities discovered by mammography. Surgical biopsy was then performed for a final evaluation of the tissue. Surgical biopsy showed that 76 (30.4 percent) of the abnormalities were cancerous (54 invasive and 22 in situ) and 174 (69.6 percent) were benign. Core biopsy detected 31 (41 percent) of the cancerous abnormalities and FNAB detected 24 (32 percent) of them. FNAB was unable to obtain adequate samples in 24 percent of the cases and core biopsy was unable to obtain adequate samples in 17 percent of cases. When taken together, the two techniques were able to detect 41 of the 76 cancers (54 percent). When only abnormalities considered not very suspicious at mammography (125) were evaluated, the two techniques taken together showed that 85 of the abnormal images were benign. All 85 were confirmed benign at surgery. No cancers were missed by the two techniques in the 125 cases. The results indicate that the two techniques could be used in conjunction with mammography findings to reduce the number of patients required to undergo surgical biopsy procedures. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Breast cancer, Breast, Breast biopsy

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Diagnosis of paraaortic and pelvic lymph node metastasis of gynecologic malignant tumors by ultrasound-guided percutaneous fine-needle aspiration biopsy

Article Abstract:

The most dangerous aspect of cancer is, of course, the propensity of cancer cells to spread to distant parts of the body. The first step in this spread is often metastasis to lymph nodes in the region of the primary cancer. Therefore, for many cancers, an important step in diagnosis and subsequent treatment is the identification of cancer cells in the lymph nodes. In gynecologic cancers, the cancer cells may first spread to pelvic lymph nodes and to the paraaortic lymph nodes in the lower back. A study was conducted to evaluate the usefulness of combining ultrasound imaging with needle biopsy for the examination of these lymph nodes. A total of 78 patients were studied; these women had cervical cancer, uterine cancer, ovarian cancer, or fallopian tube cancer. In seven cases, the cancer was not operable; ultrasound imaging indicated enlarged pelvic lymph nodes in these patients. When fine-needle aspiration biopsies were performed, guided by the ultrasound image, cancer cells were found in all seven women. In the remaining 71 cases, ultrasound imaging indicated enlarged pelvic lymph nodes in 17 women. Surgical specimens confirmed cancer cells in 11 of the 17 cases, as well as in 7 cases without enlarged lymph nodes. In 7 of the 11 cases of enlarged nodes, a needle biopsy had also been obtained; the results revealed cancer cells in 6 cases. In 41 patients, ultrasound imaging of the paraaortic lymph nodes was performed; lymph nodes were surgically removed in 20 women. Of these 20 patients, 6 had enlarged nodes which contained cancer cells. Cancer cells were also found in two cases in which the nodes were not enlarged. In five of the six cases of enlarged nodes, fine-needle biopsy guided by the ultrasound image was performed; malignant cells were found in all five. The authors suggest that these results demonstrate the potential usefulness for fine-needle biopsy guided by ultrasound imaging in the detection of cancer metastasis to the pelvic and paraaortic lymph nodes. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Ultrasound imaging, Metastasis, Cancer metastasis, Lymphatic metastasis

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