Eman Sbaity,MD Group 5 Group advisors: Lawrence Appel, MD, MPH - - PowerPoint PPT Presentation

Eman Sbaity,MD Group 5 Group advisors: Lawrence Appel, MD, MPH Elizabeth Selvin, PhD, MPH

 Assessment of the axilla is essential for breast

cancer patients to guide their therapies.

 The sentinel lymph node is the first lymph node

in the axillary lymph node basin draining the breast.

 Sentinel Lymph Node Biopsy (SLNB) is the

standard of care to evaluate the axilla in early breast cancer patients.

Axilla US FNAB SLNB Neg FNAB Pos US Neg SLNB SLNB Pos US Pos Early Breast Cancer FNAB Neg SLNB Neg SLNB Pos ALND SLNB

 Study the performance of ultrasound (US)

with Fine Needle Aspiration Biopsy (FNAB) to reliably identify a negative axilla

 By comparing US with FNAB to the standard

• f care, the SNLB

 Retrospective electronic chart review  Breast cancer patients diagnosed and treated

at Johns Hopkins Hospital

 Between January 2005-June 2011

Inclu lusio ion Criteria ria:

 Women >18 years  Histologically-confirmed diagnosis of breast

cancer

 Patients who underwent US of the axilla

with/without FNAB in their pre-operative workup followed by a SLNB

 US, FNAB, and SLNB done in our institution

Exclu clusion

• n crite

criteria ia:

 SLNB performed after neoadjuvant

chemotherapy

Axilla US FNAB SLNB Neg FNAB Pos US Neg SLNB SLNB Pos US Pos Early Breast Cancer FNAB Neg SLNB Neg SLNB Pos ALND SLNB

#SL SLNB P Pos

• s

#FNA FNAB Neg #SL SLNB P Pos

• s

#US US Neg

 Subgroup analysis will be performed to

determine the performance of the US with FNAB according to:

• Tumor size
• Tumor type (ductal or lobular)
• Tumor grade
• Tumor hormonal status
• Age of the patients
• BMI of patients

 If we can identify the subgroup of patients in

which a negative axillary US with/without FNAB reliably reflects a negative axilla, then we could spare some patients axillary surgery.

 SNLB is still an invasive procedure with real

complications.