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Sentinel lymph nodes and breast carcinoma: analysis of 70 cases by frozen section

The sentinal node biopsy (SNB) is a reliable method for determining the status of the regional lymph nodes in patients with breast cancer. SNB technology is evolving rapidly, but no standardization has yet been accomplished. The aim of this study is to discuss the accuracy of this procedure and the...

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Published in:	Annals of Saudi medicine 2005-03, Vol.25 (2), p.111-114
Main Authors:	Al-Shibli, Khalid I, Mohammed, Hiba A, Mikalsen, Kari S
Format:	Article
Language:	English
Subjects:	Breast Neoplasms - pathology Female Frozen Sections Humans Lymph Nodes - pathology Lymphatic Metastasis Original Sentinel Lymph Node Biopsy
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description	The sentinal node biopsy (SNB) is a reliable method for determining the status of the regional lymph nodes in patients with breast cancer. SNB technology is evolving rapidly, but no standardization has yet been accomplished. The aim of this study is to discuss the accuracy of this procedure and the optimal method for identifying micrometastases. We collected data from 70 women with primary invasive breast carcinoma who underwent SNB for breast cancer. We examined two frozen sections levels from each half of each lymph node, as well as a cytology imprint before arriving at the frozen section diagnosis. Immunohistochemistry with pancytokeratin (AE1/AE3) was done on the paraffin sections. For the association between the lymph node size and the possibility of metastases, Student's t test was used and a P value of less than 0.05 was regarded as significant. The number of patients with metastases in SNB was 19, from which 15 cases were correctly diagnosed in frozen sections/imprints and four cases were false negative. The axillary toilet from all cases with SNB metastases smaller than 2 mm showed no additional positive nodes. Lymph node diameter showed a significant association with sentinel node status (P
doi_str_mv	10.5144/0256-4947.2005.111
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SNB technology is evolving rapidly, but no standardization has yet been accomplished. The aim of this study is to discuss the accuracy of this procedure and the optimal method for identifying micrometastases. We collected data from 70 women with primary invasive breast carcinoma who underwent SNB for breast cancer. We examined two frozen sections levels from each half of each lymph node, as well as a cytology imprint before arriving at the frozen section diagnosis. Immunohistochemistry with pancytokeratin (AE1/AE3) was done on the paraffin sections. For the association between the lymph node size and the possibility of metastases, Student's t test was used and a P value of less than 0.05 was regarded as significant. The number of patients with metastases in SNB was 19, from which 15 cases were correctly diagnosed in frozen sections/imprints and four cases were false negative. The axillary toilet from all cases with SNB metastases smaller than 2 mm showed no additional positive nodes. Lymph node diameter showed a significant association with sentinel node status (P<0.0001). Frozen section examination of SNB from patients with breast carcinoma is both specific (100%) and sensitive (79%). Diagnosis of lobular carcinoma can be difficult, and may require immunohistochemistry with cytokeratin for diagnosis. Small metastases in a non-optimal frozen section may be difficult to discern. Cytology imprints add nothing to the diagnosis.</description><identifier>ISSN: 0256-4947</identifier><identifier>EISSN: 0975-4466</identifier><identifier>DOI: 10.5144/0256-4947.2005.111</identifier><identifier>PMID: 15977687</identifier><language>eng</language><publisher>Saudi Arabia: King Faisal Specialist Hospital and Research Centre</publisher><subject>Breast Neoplasms - pathology ; Female ; Frozen Sections ; Humans ; Lymph Nodes - pathology ; Lymphatic Metastasis ; Original ; Sentinel Lymph Node Biopsy</subject><ispartof>Annals of Saudi medicine, 2005-03, Vol.25 (2), p.111-114</ispartof><rights>Copyright © 2005, Annals of Saudi Medicine 2005</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c466t-54719fb4ea4faa83ba75f641950c6cbe3328c814d399d1c266f227b9249db5953</citedby><cites>FETCH-LOGICAL-c466t-54719fb4ea4faa83ba75f641950c6cbe3328c814d399d1c266f227b9249db5953</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6147972/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6147972/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15977687$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Al-Shibli, Khalid I</creatorcontrib><creatorcontrib>Mohammed, Hiba A</creatorcontrib><creatorcontrib>Mikalsen, Kari S</creatorcontrib><title>Sentinel lymph nodes and breast carcinoma: analysis of 70 cases by frozen section</title><title>Annals of Saudi medicine</title><addtitle>Ann Saudi Med</addtitle><description>The sentinal node biopsy (SNB) is a reliable method for determining the status of the regional lymph nodes in patients with breast cancer. SNB technology is evolving rapidly, but no standardization has yet been accomplished. The aim of this study is to discuss the accuracy of this procedure and the optimal method for identifying micrometastases. We collected data from 70 women with primary invasive breast carcinoma who underwent SNB for breast cancer. We examined two frozen sections levels from each half of each lymph node, as well as a cytology imprint before arriving at the frozen section diagnosis. Immunohistochemistry with pancytokeratin (AE1/AE3) was done on the paraffin sections. For the association between the lymph node size and the possibility of metastases, Student's t test was used and a P value of less than 0.05 was regarded as significant. The number of patients with metastases in SNB was 19, from which 15 cases were correctly diagnosed in frozen sections/imprints and four cases were false negative. The axillary toilet from all cases with SNB metastases smaller than 2 mm showed no additional positive nodes. Lymph node diameter showed a significant association with sentinel node status (P<0.0001). Frozen section examination of SNB from patients with breast carcinoma is both specific (100%) and sensitive (79%). Diagnosis of lobular carcinoma can be difficult, and may require immunohistochemistry with cytokeratin for diagnosis. Small metastases in a non-optimal frozen section may be difficult to discern. 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Lymph node diameter showed a significant association with sentinel node status (P<0.0001). Frozen section examination of SNB from patients with breast carcinoma is both specific (100%) and sensitive (79%). Diagnosis of lobular carcinoma can be difficult, and may require immunohistochemistry with cytokeratin for diagnosis. Small metastases in a non-optimal frozen section may be difficult to discern. Cytology imprints add nothing to the diagnosis.</abstract><cop>Saudi Arabia</cop><pub>King Faisal Specialist Hospital and Research Centre</pub><pmid>15977687</pmid><doi>10.5144/0256-4947.2005.111</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record>
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subjects	Breast Neoplasms - pathology Female Frozen Sections Humans Lymph Nodes - pathology Lymphatic Metastasis Original Sentinel Lymph Node Biopsy
title	Sentinel lymph nodes and breast carcinoma: analysis of 70 cases by frozen section
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