Frozen section evaluation of sentinel lymph nodes in breast carcinoma: a retrospective analysis

Russo, Leonardo; Betancourt, Luís; Romero, Gabriel; Godoy, Alí; Bergamo, Laura; Delgado, Rafael Castro; Ruiz, Ángela; Gutiérrez, M. Recaj; Salas, Eduardo; Puzzi, Maria

doi:10.3332/ecancer.2017.774

Cited by 12 publications

(6 citation statements)

References 18 publications

(18 reference statements)

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“…They showed that TIC had lower sensitivity but much greater specificity, which is not in agreement with our findings 22 . Russo et al demonstrated that FSA had an acceptable false‐negative rate during SLN biopsy 23 . Regardless of the diagnostic value of each technique, the cost of each technique is also critical for both healthcare providers and patients.…”

Section: Discussioncontrasting

confidence: 57%

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

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Hosseinzadeh

Farahi

et al. 2021

Diagnostic Cytopathology

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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.

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Section: Discussioncontrasting

confidence: 57%

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

Avval

Hosseinzadeh

Farahi

et al. 2021

Diagnostic Cytopathology

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“…Notably, one of the most consistent features associated with SLN FS FN in the literature is small ( 2 mm) micrometastasis. [24][25][26][27] In this study, SLN FS FN was seen in 21 patients, comprising 4.8% of all cases and 22.5% of all cases with final positive SLN status. However, most (14 of 21; 66.7%) were micrometastases, and 4 patients with macrometastases had other intraoperatively identified positive SLNs, 3 of whom underwent ALND during the same procedure and 1 of whom had her intraoperative course dictated by trial protocol.…”

Section: Discussionmentioning

confidence: 52%

Breast Sentinel Lymph Node Frozen Section Practice: An Enterprise Audit as a Guide for Moving Forward

Czaja

Jorns

2020

Archives of Pathology &Amp; Laboratory Medicine

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Context.— In recent years, there has been a shift to less aggressive surgical management of the axilla in breast cancer. Consequently, sentinel lymph node evaluation by frozen section (FS) has declined. Additionally, there has been an impetus to decrease efforts in identifying small sentinel lymph node metastases. Objectives.— To critically evaluate our enterprise performance in evaluating axillary sentinel lymph node submitted for FS prior to considering changes in processing. Design.— A retrospective review (August 1, 2017–July 31, 2019) was conducted to identify sentinel and nonsentinel lymph nodes from 1 academic institution and 2 community sites. Cases were evaluated for grossing technique and discordance between FS and permanent section (PS) due to sampling and/or interpretive error. Clinicopathologic features were assessed. Results.— Lymph nodes from 426 patients with 432 neoplasms were sent for FS. Serial sectioning at 2-mm intervals was adhered to in 338 of 432 (78.2%). Serial sectioning was significantly lower at the community sites (14 of 60; 23.3%) versus at the academic institution (324 of 372; 87.1%; P < .001). Discordant cases were all false negatives (21 of 432; 4.8%). A total of 7 of 21 false negatives (33.3%) had macrometastatic (>2 mm) disease; of these, 3 were post–neoadjuvant chemotherapy, 3 were neither serially sectioned nor posttherapy, and 1 was a small (0.3-cm) focus. A total of 15 of 16 false negatives due to sampling error were detected on the first permanent section level. Conclusions.— Standard serial sectioning of sentinel lymph node at 2-mm intervals resulted in infrequent false negatives due to macrometastatic disease. A single additional permanent section level is reasonable, given adherence to serial sectioning.

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“…False negative patients that are more likely to detect metastasis like micro metastasis or isolated tumor cell or have less 2 lymph nodes involvement, however, re-surgical procedures can be discarded. In fact, the use of new protocols to deal with different situations of lymph node involvement can prevent the complications of axillary dissection and reduce the stress of patients due to the need for re-surgery, and therefore the use of frozen section is not necessary and in this study, has not reduced the risk of re-surgery (Russo et al, 2017;van der Noordaa et al, 2017). One of the shortcomings of this study was the low number of patients.…”

Section: Discussionmentioning

confidence: 84%

Is Necessary Intraoprative Frozen Section In Sentinel Lymph Node Biopsy For Breast Cancer Patients?

Godazande

Moradi

Naghshvar

et al. 2020

Asian Pac J Cancer Prev

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Background: Improvements in the process of staging and surgical treatment of axillary lymph nodes in recent years, have led to the use of intra operative frozen section pathology to examine the sentinel lymph node biopsy in breast cancer patients. Materials and Methods: we evaluated the results of the Sentinel biopsy in 102 patients with early stage breast cancer, which were negative clinical lymph nodes, and analyzing the true positive and false negative rate, diagnostic accuracy of frozen section lymph node biopsy. It also studied the factors affecting the sentinel and non-sentinel lymph nodes in patients treated by axillary lymph dissection. Results: In this study, we investigated 102 patients' stage 1and 2 breast cancer with clinical negative axillary lymph node and candidates for sentinel lymph node biopsy, were placed under investigation. 15.7 % of the real positive results of sentinel and 62.7 % of the real negative and 2 % false positives and 20.9 % false negative results and% 78. 4 diagnostic accuracy, has been frozen section. Among the patients who were initially or delayed in the axillary dissection, 37% had more than two lymph nodes. While in general, 16.7% of patients had a need for axillary lymph node dissection based on z11 criteria. Lymph-vascular invasion was a major contributor to lentil involvement in Sentinel and non-Sentinel nodes. Conclusion: Frozen section pathology during the operation of sentinel lymph node biopsy has been initiated to prevent the need for a reoperation in early stage breast cancer patients. However, due to low tumor burden in patients who are candidates for this procedure, and the constraints in the initial sections and their false negative results, also the removal of frozen section will not have an effect on the rate of increasing reoperation and can be effective in reducing the time and cost of surgery.

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Frozen section evaluation of sentinel lymph nodes in breast carcinoma: a retrospective analysis

Cited by 12 publications

References 18 publications

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

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

Breast Sentinel Lymph Node Frozen Section Practice: An Enterprise Audit as a Guide for Moving Forward

Is Necessary Intraoprative Frozen Section In Sentinel Lymph Node Biopsy For Breast Cancer Patients?

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