Imprint cytology versus frozen section: intraoperative analysis of sentinel lymph nodes in breast cancer

Abstract

Intraoperative analysis of sentinel lymph nodes in breast cancer can be performed quickly. Imprint cytology and frozen section show comparable accuracy in predicting sentinel node status.

Meta-analysis of sentinel node imprint cytology in breast cancer

“…In five of these studies 7,20,34,44,45 not all of the patients had both techniques performed; they were excluded from analysis to avoid the introduction of bias. Independent assessment of the touch imprint and frozen section methods was performed by Nagashima et al 5 The same pathologist examined both the frozen section and the imprint in the study of Sauer et al 29 .…”

“…There were nine studies in which the sentinel lymph node was processed for frozen section examination after an imprint cytology slide had been prepared 5,7,12,20,29,33,34,44,45 . In five of these studies 7,20,34,44,45 not all of the patients had both techniques performed; they were excluded from analysis to avoid the introduction of bias.…”

“…Several reports involved the use of rapid immunohistochemical 19,20,27,33,34,53 or immunofluorescence 28 stains, with results superior to those of ordinary stains. However, use of these stains is constrained by cost, availability and the time taken to prepare the specimen.…”

“…If there were inconsistencies in the published data, study authors were contacted for clarification. Two studies 19,20 considered false-positive results as being true positives on the basis that the cells seen on cytological examination were a micrometastatic focus that had been completely removed from the cut surface by imprinting. These few cases were reclassified as false positives.…”

Factors associated with the misdiagnosis of sentinel lymph nodes using touch imprint cytology for early stage breast cancer

“…This process can be achieved by means of frozen sectioning (FS) and touch imprint cytology (TIC). Results of numerous studies showed that TIC has a sensitivity equivalent to or even better than that of FS (2)(3)(4)(5), since TIC offers the advantages of minimal tissue preparation, rapid staining and good cytological detail for interpretation. No special equipment is required and no tissue loss occurs (6).…”