Testing the feasibility of intra-operative sentinel lymph node touch imprint cytology

Jahromi, Alireza Hamidian; Narayanan, Sankaran; MacNeill, Fiona; Osin, Peter; Nerurkar, Ashutash; Gui, Gerald

doi:10.1308/003588409x391758

Cited by 9 publications

(3 citation statements)

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“…Furthermore, touch imprint cytology sensitivity is dependent on the burden of disease on a bivalved lymph node. 33 Therefore, micrometastatic disease can easily be missed.…”

Section: Discussionmentioning

confidence: 99%

Is Intraoperative Imprint Cytology Evaluation Still Feasible for the Evaluation of Sentinel Lymph Nodes for Lobular Carcinoma of the Breast?

et al. 2011

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Background The evaluation of sentinel lymph nodes (SLNs) from a patient with lobular breast cancer is challenging. Metastatic lobular cancer is difficult to identify in SLNs because of its low-grade cytomorphology and its tendency to resemble lymphocytes. Intraoperative imprint cytology (IIC) is a rapid, reliable method for evaluating SLNs intraoperatively. We sought to reexamine our experience with this technique in the identification of invasive lobular breast cancer SLN metastases. Methods A retrospective review of a prospectively maintained database of IIC results of 1010 SLN mapping procedures for breast cancer was performed. From this cohort we reviewed SLN cases of lobular cancer. The SLNs were evaluated intraoperatively by bisecting the SLN. Imprints were made of each cut surface and stained with hematoxylin and eosin (H&E) and Diff-Quik. Permanent sections were evaluated with up to 4 H&E-stained levels and cytokeratin immunohistochemistry. IIC results were compared with final pathologic results. Results A total of 67 cases of pure invasive lobular cancer were identified. The sensitivity was 71%, specificity was 100%, and accuracy was 92%. No statistically significant differences in sensitivity, specificity, or accuracy were identified between the intraoperative detection of lobular carcinoma vs ductal carcinoma. The specificity has remained the same since 2004. However the accuracy (82% vs 92%; P = .09) and sensitivity (52% vs 71%; P = .02) has improved since 2004. Conclusions As we have previously shown, the sensitivity and specificity of IIC in evaluating lobular carcinoma is feasible and accurate. IIC continues to be a viable alternative to frozen section for intraoperative evaluation.

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“…Furthermore, touch imprint cytology sensitivity is dependent on the burden of disease on a bivalved lymph node. 33 Therefore, micrometastatic disease can easily be missed.…”

Section: Discussionmentioning

confidence: 99%

Is Intraoperative Imprint Cytology Evaluation Still Feasible for the Evaluation of Sentinel Lymph Nodes for Lobular Carcinoma of the Breast?

et al. 2011

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“…In the study by Asthana et al, the average time taken for reporting the IC for lymph nodal metastasis in head and neck cancer was 15 minutes 3 . Jahromi et al assessed the feasibility of sentinel lymph node using Touch IC in carcinoma breast 20 . The average time for reporting in this study was 25.7 ± 6.4 minutes.…”

Section: Discussionmentioning

confidence: 65%

Comparison of intraoperative imprints cytology with frozen section for lymph node metastasis in patients with head and neck squamous cell carcinoma

Neduvanchery

Gochhait

Srinivas

et al. 2020

Diagnostic Cytopathology

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BackgroundIntraoperative evaluation of lymph nodal metastasis in head and neck squamous cell carcinoma (HNSCC) assumes importance and avoids over‐treatment in clinically node negative (N0) neck. Frozen section (FZ) is the commonly employed technique, but it requires significant investment in resources, time, and personnel. Intraoperative imprint cytology (IC) is a rapid, reliable, and inexpensive alternative. We conducted a prospective study to assess the diagnostic accuracy of intraoperative IC and FZ for lymph node metastasis in HNSCC.MethodsAll patients presenting with HNSCC with clinically N0 neck undergoing surgery were included in the study, and intraoperative assessment of clinically suspicious nodes was done using IC and FZ and was reviewed by two independent pathologists. The sensitivity, specificity, and accuracy of IC and FZ were calculated with reference to the final histopathology report. The time duration for reporting was calculated.ResultsThirty‐four patients with clinically N0 neck were included in the study, and 85 slides were examined. The sensitivity, specificity, and accuracy of FZ were 100%, 98.6%, and 98.9%, respectively, whereas for IC, it was 85.7%, 95.8%, and 94.1%, respectively. The mean time duration for reporting for FZ and IC was 41.18 ± 3.62 and 18.12 ± 2.01 minutes, respectively.ConclusionIC provides a cheaper, accurate, and rapid alternative for FZ for intraoperative assessment of neck nodes in HNSCC, and it assumes importance in resource‐driven countries like India.

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“…In addition, non‐ductal histological subtype and the absence of lymphovascular invasion were identified as significant independent factors associated with a higher FNR. Wide ranges of sensitivity (34–96.9%) and specificity (96.3–100%) have been reported for cytological techniques . A meta‐analysis of 31 studies of IC identified an overall sensitivity of 63%, and the pooled sensitivity for detection of macrometastases was higher than for micrometastases (81% versus 22%) .…”

Section: Intraoperative Evaluation (Ioe) Of Slnsmentioning

confidence: 99%

Sentinel lymph nodes for breast carcinoma: an update on current practice

Maguire

Brogi

2015

Histopathology

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Sentinel lymph node (SLN) biopsy has been established as the standard of care for axillary staging in patients with invasive breast carcinoma and clinically negative lymph nodes (cN0). Historically, all patients with a positive SLN underwent axillary lymph node dissection (ALND). The ACOSOG Z0011 trial showed that women with T1-T2 disease and cN0 who undergo breast conserving surgery and whole-breast radiotherapy can safely avoid ALND. The main goal of SLN examination should be to detect all macrometastases (>2mm). Gross sectioning SLNs at 2 mm intervals and microscopic examination of one H&E-stained section from each SLN block is the preferred method of pathologic evaluation of SLNs. The role and timing of SLN biopsy for patients having neoadjuvant chemotherapy is controversial and continues to be explored in clinical trials. SLN biopsies from patients with invasive breast carcinoma who have received neoadjuvant chemotherapy pose particular challenges for pathologists.

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Testing the feasibility of intra-operative sentinel lymph node touch imprint cytology

Abstract: Intra-operative sentinel lymph node assessment using touch imprint cytology is feasible within a busy NHS practice. We now offer touch imprint cytology to patients following appropriate counselling.

Cited by 9 publications

References 0 publications

Is Intraoperative Imprint Cytology Evaluation Still Feasible for the Evaluation of Sentinel Lymph Nodes for Lobular Carcinoma of the Breast?

Is Intraoperative Imprint Cytology Evaluation Still Feasible for the Evaluation of Sentinel Lymph Nodes for Lobular Carcinoma of the Breast?

Comparison of intraoperative imprints cytology with frozen section for lymph node metastasis in patients with head and neck squamous cell carcinoma

Sentinel lymph nodes for breast carcinoma: an update on current practice

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