Outcomes and bioethical implications of lymphadenectomy in mastectomized patients: Importance and indication of ultrasound-guided fine-needle aspiration biopsy

Huertas-Moreno, Marta Y Gonzalvo-Cirac, Margarita (2023) Outcomes and bioethical implications of lymphadenectomy in mastectomized patients: Importance and indication of ultrasound-guided fine-needle aspiration biopsy. Universidad y Salud, 25 (1). D6-D14. ISSN 2389-7066

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Resumen

Introduction: Lymph node involvement is the main prognostic factor in breast cancer. Mastectomized patients usually undergo lymphadenectomy (LA) of micrometastatic sentinel lymph nodes (SLNs) despite the evidence of AMAROS trial to replace this therapy with radiotherapy in select cases. Objective: Demonstrate the ability of ultrasonography to detect non-metastatic or micrometastatic SLNs. Materials and methods: 132 patients who underwent mastectomy were evaluated. Ultrasound-guided fine-needle aspiration biopsy (FNAB) was indicated for suspicious lymph nodes. LA and SNL biopsy (SLNB) were performed in patients with positive and negative FNAB, respectively. LA was performed in FNAB positive or SLNB positive cases, except in the presence of isolated tumor cells and micrometastatic SLNs. The tumor burden after LA in patients with negative FNAB and positive SLNB was measured; the presence of two or fewer positive SLNs was considered a low burden. Results: Sensitivity of FNAB for detecting positive lymph nodes in patients with a high tumor burden was 93% and specificity was 84%. Positive (PPV) and negative predictive value (NPV) were 60% and 79%, respectively. Conclusions: LA could have been avoided in 90% of mastectomized patients with negative FNAB and a low tumor burden who met the AMAROS criteria with a high NPV (79%).

Tipo de Elemento:	Artículo
Palabras Clave:	Bioethics; breast cancer; sentinel lymph node; public health; lymphedema
Asunto:	Q Ciencias > Q Science (General) R Medicina > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Division:	Revistas > Revista Universidad y Salud
Depósito de Usuario:	Rev. Universidad y Salud UDENAR
Fecha Deposito:	21 Mar 2023 23:10
Ultima Modificación:	21 Mar 2023 23:10
URI:	http://sired.udenar.edu.co/id/eprint/7669

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