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.

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

 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 of 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 on crite criteria ia:  SLNB performed after neoadjuvant chemotherapy

FNAB ALND Pos US FNAB Pos #SL SLNB P Pos os #FNA FNAB Neg SLNB Pos FNAB SLNB Neg Early Axilla SLNB Breast US Neg Cancer #SL SLNB P Pos os #US US Neg SLNB US Pos SLNB Neg SLNB 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.