Comparing scraping cytology with touch imprint cytology and frozen section analysis in the intraoperative diagnosis of sentinel lymph node metastasis in breast cancer

Abstract

Background Breast cancer is a common cancer in the female population. Sentinel lymph node (SLN) in breast cancer patients can be evaluated by different methods including intraoperative frozen section analysis (FSA), touch imprint cytology (TIC), and scraping cytology (SC). In this study, in addition to investigating TIC and FSA, we focused on SC to evaluate the diagnostic value of this almost new method. Materials and methods In this retrospective study, the quadrantectomy and sentinel lymph node resection of 150 specimens with mammography and core needle biopsy‐confirmed breast cancer were examined. Of the 150 participants, 77 and 73 had negative and positive results for the permanent pathology of SLN metastasis, respectively. Intra‐operative FSA, TIC, and SC for SLN were performed for the patients and all were confirmed by permanent pathology. Results All the specimens were taken from females aged between 25 and 82 years. The sensitivity and specificity of TIC, FS, and SC were 73% and 50%, 92.6% and 50%, and 92.1% and 50%, respectively. Among the three techniques, TIC had the lowest positive and negative predictive values. However, FS had the highest positive predictive value whereas SC had the highest negative predictive value. Conclusion In addition to FS and TIC as rapid, cost‐effective, and reliable diagnostic methods in SLN metastasis, SC is an acceptable and highly sensitive method. A combination of these methods may provide a more favorable diagnostic value for SLN assessment in breast cancer patients.

A prospective comparison of a modified miniaturised hand‐held epifluorescence microscope and touch imprint cytology for evaluation of axillary sentinel lymph nodes intraoperatively in breast cancer patients

“…Additionally, the image quality scores, according to a junior pathologist, indicated that MEW‐M had superior image quality than TIC, with a median score of 3.1 vs 2.1 ( p < 0.0001). Furthermore, the lower cellular content and incomplete pathological structure in TIC made interpretation more challenging, such that a dedicated pathologist was required to resolve the issue 26 . From this perspective, promoting the use of MEW‐M in clinical settings could prove beneficial.…”

“…Furthermore, the lower cellular content and incomplete pathological structure in TIC made interpretation more challenging, such that a dedicated pathologist was required to resolve the issue. 26 From this perspective, promoting the use of MEW-M in clinical settings could prove beneficial.…”

Label‐free multiphoton excitation imaging as a promising diagnostic tool for breast cancer

“…We assume that our MPM imaging method is promising, especially in intraoperative rapid diagnosis. Although it is critical to reduce the excision range in cancer surgery, 1 , 2 , 3 suboptimal accuracy is one of the most important concerns. This is partly attributed to sampling error caused by the limited observable area of the frozen section.…”

“…Moreover, histopathology plays an important role in the final diagnosis and intraoperative rapid diagnosis, which is critical for reducing the excision range in cancer surgery. 1 , 2 , 3 However, some problems are associated with typical histopathology‐based diagnostic procedures. Conventional methods can provide only planar two‐dimensional images; thus, it is not possible to observe three‐dimensional structures in diverse anatomical structures consisting of various cells.…”

“…With stained tissue preparations and bright‐field microscopy, pathologists estimate or judge different types of histopathological findings such as cell malignancy, the degree of inflammation and fibrosis, the depth of tumor invasion, and metastasis status. Moreover, histopathology plays an important role in the final diagnosis and intraoperative rapid diagnosis, which is critical for reducing the excision range in cancer surgery 1–3 . However, some problems are associated with typical histopathology‐based diagnostic procedures.…”