Aims: The success of the ‘Sentinel Node Biopsy’ (SNB) in determining the axillary lymph node status necessitates an accurate and rapid method for intraoperative examination of the nodes in order to selectively operate on positive axillae during the same operative session. The aim of the study was to determine the feasibility and accuracy of IHC stained touch imprints in detecting axillary nodal metastases intraoperatively. Three hundred and forty‐four axillary nodes from 30 patients [23 axillary node clearance (ANC), 2 axillary node sampling (ANS) and 5 SNB], were bisected, imprinted and stained with IHC. Results were compared with those of H&E sections of the same nodes.
Results: Using IHC, 29 nodes from 9 patients were positive for metastases. Using H&E, 28 nodes from 8 patients were positive, resulting in 30 per cent and 27 per cent positive cases and 8.4 per cent and 8.1 per cent positive nodes for IHC and H&E, respectively. On a patient basis, sensitivity was 100 per cent and 89 per cent, and negative predictive value (NPV) was 100 per cent and 95.5 per cent for IHC and H&E, respectively. On a node basis, sensitivity was 96.7 per cent and 93.3 per cent and NPV was 99.6 per cent and 99.5 per cent for IHC and H&E, respectively. Because of the absence of false positives, specificity and positive predictive value (PPV) were 100 per cent for both IHC and H&E. With ANS and SNB procedures, results were obtained within 35–50 min depending on the number of the nodes given.
Conclusion: These results indicate that IHC stained touch imprints can provide a fast and sensitive method for detecting metastases in axillary nodes during breast cancer surgery.
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