Axillary lymph node staging is one of the most important prognostic indicator of outcome in patients with breast cancer [1]. Currently, sentinel lymph node biopsy is used as an initial approach of the axilla in most patients with breast cancer [2]. With the development of adjuvant treatment studies have shown that depending on the tumor characteristics the approach of the axilla can be less invasive [3]. Ultrasound has been used as the primary imaging method to evaluate axillary lymph nodes in breast cancer in several...

· Study’s design and patient selection: This was a prospective study, approved by our institutional ethics committee in 12/2011, and included 182 patients referred to the Institute of Cancer of São Paulo with newly diagnosed primary invasive breast cancer from April 2012 to April 2014. After signing the informed consent form, all patients were submitted to ultrasound evaluation of the ipsilateral axilla and fine needle aspiration (FNA). Exclusion criteria were as follow: patients with ductal carcinoma in situ, patients who had done neoadjuvant treatment before...

The mean age of the patients in the study group, 182 women, was 56 years (range 31-93 years). Relative to localization of the tumor, 81 were located in the right breast, 100 in the left breast and 1 tumor was bilateral, total 183 axillae included in the study. Out of these, 74 patients had surgery as the primary treatment and 72 had neoadjuvant treatment; after surgery, 19 patients are in palliative care, 11 died and 6 lost follow up in our institution. The primary cancer...

In patients with newly diagnosed invasive breast cancer axillary ultrasound and ultrasound-guided FNA are a useful method of screening, helping to decide which is the better systemic and axillary approach. Depending on ultrasound and tumor characteristics we could spare FNA and direct the patient to sentinel lymphadenectomy or neoadjuvant treatment. In our study, ultrasound-guided FNA brought no benefit in patients with axillary lymph nodes classified on ultrasound as normal, independently of tumor characteristics. All FNA cytology results were negative or inconclusive when the lymph nodes...

References: 1. Carter CL, Allen C, Henson DE. Relation of tumor size, lymph node status, and survival in 24,740 breast cancer cases. Cancer. 1989 Jan 1;63(1):181-7. 2. Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg. 1994 Sep;220(3):391-8; discussion 398-401. 3. Giuliano AE, Hunt KK, Ballman KV, Beitsch PD, Whitworth PW, Blumencranz PW, Leitch AM, Saha S, McCall LM, Morrow M. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node...