الفهرس 
Management of indeterminate axillary lymph nodes in early stage breast cancer
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Abstract
Background: Breast cancer is the most common female cancer with the incidence increasing in the past two decades. Axillary lymph node status is an important prognostic factor and determinant of treatment for patients with breast carcinoma. Ultrasonographic (US) evaluation of the breast and axilla is increasingly being used in the preoperative evaluation of breast cancer patients and it can classify lymph nodes into pathological , indeterminate and benign. Patients and Methods: This prospective study conducted on 20 Female patients with early breast cancer were admitted to the breast surgery department in kasr alainy medical school hospitals, Cairo University from Ocober 2017 till March 2018. We assessed sensitivity, specificity, and positive and negative predictive value of preoperative ultrasound guided FNAC from patients with indeterminate lymph nodes in contrary to SLNB and post-operative histopathological results of the ALND . Results: The sensitivity of the FNAC was found to be 75% with the NPV = 83.33%, and the specificity was 83.3% while PPV = 75.%.while the sensitivity of and SLNB was found to be 83.33% . Accuracy of FNAC was the same as SLNB in indeterminate lymh nodes group which was 80%. Conclusions: Fine needle aspiration cytology has almost no morbidity. The procedure is quick, minimally invasive and barely painful. However , FNAC is only moderately sensitive (75%),. Inadequate (insufficient) sampling is another potential limit of FNAC and its operator-dependent technique.In addition , FNAC does not identify all metastases in the axilla so there will be lack of assessment of axillary Lymph nodes specially the sentinel ones which might change the decision of treatment if the patient was a eligible for Z0011({u2264} 2/3 or more , not matted and with no extracpuslar extention) and might avoid ALND