The results of frozen section, touch preparation, and cytological smear are comparable for intraoperative examination of sentinel lymph nodes: A study in 133 breast cancer patients Journal Article

  

Authors:	Brogi, E.; Torres-Matundan, E.; Tan, L. K.; Cody, H. S. 3rd
Article Title:	The results of frozen section, touch preparation, and cytological smear are comparable for intraoperative examination of sentinel lymph nodes: A study in 133 breast cancer patients
Abstract:	Background: The goal of intraoperative sentinel lymph node (SLN) examination is to avoid reoperation for a positive SLN, but the ideal method of intraoperative SLN examination remains unclear, and published results vary widely. Methods: We evaluated the sensitivity of intraoperative frozen section (FS), touch preparation (TP), and cytological smear (CS) in 305 SLNs from 133 breast cancer patients. Each SLN was received fresh and cut into 2- to 3-mm slices; TP and CS from each cut surface and an FS of the entire SLN were obtained. Postoperative evaluation of the SLN consisted of 1 hematoxylin and eosin-stained section and of one hematoxylin and eosin-stained and one immunohistochemically stained section for cytokeratin from each of two levels 50 μm apart. Tumor cells found by any method, including immunohistochemistry, identified a positive SLN. Three pathologists blinded to the final SLN diagnosis reviewed all TP, CS, and FS; the consensus diagnosis (concordance of two or more) was used for the study. Results: FS, TP, and CS had comparable sensitivities (59%, 57%, and 59%, respectively). Each method was more sensitive in detecting macrometastases (>2 mm; 96%, 93%, and 93%, respectively) than micrometastases (≤2 mm; 27%, 27%, and 30%, respectively). The combination of methods only marginally improved the intraoperative sensitivity. TP and CS were each responsible for a single false-positive result. Conclusions: FS, TP, and CS are comparable for the intraoperative detection of SLN metastases, and each method is substantially better at detecting micrometastases than micrometastases. The combination of two or more techniques only marginally improves the sensitivity over that achieved by a single method. © 2005 The Society of Surgical Oncology, Inc.
Keywords:	immunohistochemistry; adult; controlled study; human tissue; aged; middle aged; postoperative period; comparative study; lymph node metastasis; cancer diagnosis; lymph nodes; lymphatic metastasis; diagnostic accuracy; sentinel lymph node biopsy; diagnostic procedure; breast cancer; breast neoplasms; tissue section; diagnostic value; intraoperative period; tumor cell; intermethod comparison; eosin; hematoxylin; axilla; frozen section; frozen sections; cytodiagnosis; imprint cytology; micrometastases; touch preparation; dcis; invasive breast carcinoma; macrometastases; cytological smear
Journal Title:	Annals of Surgical Oncology
Volume:	12
Issue:	2
ISSN:	1068-9265
Publisher:	Springer
Date Published:	2005-02-01
Start Page:	173
End Page:	180
Language:	English
DOI:	10.1245/aso.2005.03.067
PUBMED:	15827799
PROVIDER:	scopus
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-16844373236&partnerID=40&md5=ba662fc71e5924678a32e20eb01f3d56
Notes:	--- - "Cited By (since 1996): 61" - "Export Date: 24 October 2012" - "CODEN: ASONF" - "Source: Scopus"

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