The purpose of this study was to stage the axilla by USG guided FNAC in clinically node negative cases and whether cumbersome procedure of sentinel lymph node dissection in breast carcinoma can be avoided for staging of axilla. The present study was carried out in Department of Surgery, IGMC, Shimla in collaboration with the departments of Radiodiagnosis and Pathology over a period of 12 months from 1st July 2015 to 30th June 2016 on 40 patients. Patients of diagnosed breast carcinoma and clinically node negative axilla were included in this study. Ultrasound guided FNAC of suspicious axillary lymph nodes was obtained in every case and sent for histopathology and these findings were compared with those of breast surgery specimen. Majority of the patients in the study were above the age of 50 years (75%). Ultrasound guided FNAC of suspicious axillary The sensitivity, positive predictive value, and negative predictive value of Axillary USG alone were 85.71%, 80%, and 60% respectively. The overall diagnostic accuracy was 75%.The sensitivity, specificity, positive predictive value and negative predictive value of Axillary USG guided FNAC were 91.66%, 100%, 100%, and 75% respectively. The overall diagnostic accuracy of USG guided FNAC was (93%). We conclude that Ultrasound guided FNAC of non-palpable indeterminate and suspicious axillary lymph nodes is a simple, minimally invasive and reliable technique for the initial determination of axillary lymph node status in breast carcinoma patients and can be immensely valuable in planning the appropriate management of patients, if adopted into routine clinical practice. Patients who have suspicious nodes on ultrasonogram and a subsequently positive FNAC can be considered node-positive and are recommended to undergo Axillary lymph node dissection at the time of primary breast surgery and sentinel lymph node biopsy can be avoided which is much cumbersome and time consuming procedure.
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