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New biopsy technique helps assess breast cancer's spread

ANN ARBOR, Mich. -- A key question after a cancer diagnosis is whether the cancer has spread to nearby lymph nodes. Researchers at the University of Michigan Comprehensive Cancer Center have found a new non-surgical technique that can help doctors determine when breast cancer has invaded the lymph nodes, sparing some women an extra trip to the operating room.

The technique, which uses ultrasound along with a fine needle biopsy, is a reliable way of determining whether the lymph nodes are malignant, according to research results being presented Monday, Nov. 29, at the Radiological Society of North America's annual meeting in Chicago.

Traditional ways of determining cancer's spread to the axilla, or underarm, are sentinel lymph node sampling, in which the first lymph node is identified and assessed for cancerous cells, or axillary lymph node dissection, in which all the lymph nodes in the underarm are removed and examined for cancer. If the sentinel node biopsy shows cancer, then a patient needs to return to the operating room to have the lymph nodes removed.

For some women, chemotherapy may be necessary before surgery, in which case, doctors must determine whether the lymph nodes are affected before the chemotherapy begins. Rather than undergo a sentinel lymph node sampling surgery, doctors can use ultrasound-guided fine needle aspiration to confirm the cancer's spread without surgery.

"The goal of the study was to use ultrasound to pre-operatively assess the axillary lymph nodes. If we can use ultrasound to stage the axilla and identify metastatic disease, we can save some women the additional surgery," says Alexis Nees, M.D., clinical assistant professor of Radiology at the U-M Medical School. Nees will present the results at the RSNA meeting.

The technique uses ultrasound to identify the axillary lymph nodes and determine if their appearance is normal or abnormal. If they look abnormal, a small 22-gauge needle is inserted in
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