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Open Access 01-12-2006 | Research

Frozen section is superior to imprint cytology for the intra-operative assessment of sentinel lymph node metastasis in Stage I Breast cancer patients

Authors: Miki Mori, Keiichiro Tada, Motoko Ikenaga, Yumi Miyagi, Seiichiro Nishimura, Kaoru Takahashi, Masujiro Makita, Takuji Iwase, Fujio Kasumi, Mituru Koizumi

Published in: World Journal of Surgical Oncology | Issue 1/2006

Abstract

Background

A standard intra-operative procedure for assessing sentinel lymph node metastasis in breast cancer patients has not yet been established.

Patients and methods

One hundred and thirty-eight patients with stage I breast cancer who underwent sentinel node biopsy using both imprint cytology and frozen section were analyzed.

Results

Seventeen of the 138 patients had sentinel node involvement. Results of imprint cytology included nine false negative cases (sensitivity, 47.1%). In contrast, only two cases of false negatives were found on frozen section (sensitivity, 88.2%). There were two false positive cases identified by imprint cytology (specificity, 98.3%). On the other hand, frozen section had 100% specificity.

Conclusion

These findings suggest that frozen section is superior to imprint cytology for the intra-operative determination of sentinel lymph node metastasis in stage I breast cancer patients.

Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, Intra M, Veronesi P, Robertson C, Maisonneuve P: A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med. 2003, 349: 546-553. 10.1056/NEJMoa012782.CrossRefPubMed

D'Errico A, Grassigli A, Gruppioni E, Fiorentino M, Corti B, Gabusi E, Morselli-Labate AM, Grigioni WF: Thorough intraoperative analysis of breast sentinel lymph node biopsies: histologic and immunohistochemical findings. Surgery. 2004, 135: 248-254. 10.1016/j.surg.2003.10.002. discussion 255-247, 357CrossRefPubMed

Dixon JM, Mamman U, Thomas J: Accuracy of intraoperative frozen-section analysis of axillary nodes. Edinburgh Breast Unit team. Br J Surg. 1999, 86: 392-395. 10.1046/j.1365-2168.1999.01054.x.CrossRefPubMed

Lee A, Krishnamurthy S, Sahin A, Symmans WF, Hunt K, Sneige N: Intraoperative touch imprint of sentinel lymph nodes in breast carcinoma patients. Cancer. 2002, 96: 225-231. 10.1002/cncr.10721.CrossRefPubMed

Menes TS, Tartter PI, Mizrachi H, Smith SR, Estabrook A: Touch preparation or frozen section for intraoperative detection of sentinel lymph node metastases from breast cancer. Ann Surg Oncol. 2003, 10: 1166-1170. 10.1245/ASO.2003.04.023.CrossRefPubMed

Motomura K, Inaji H, Komoike Y, Kasugai T, Nagumo S, Noguchi S, Koyama H: Intraoperative sentinel lymph node examination by imprint cytology and frozen sectioning during breast surgery. Br J Surg. 2000, 87: 597-601. 10.1046/j.1365-2168.2000.01423.x.CrossRefPubMed

Ratanawichitrasin A, Biscotti CV, Levy L, Crowe JP: Touch imprint cytological analysis of sentinel lymph nodes for detecting axillary metastases in patients with breast cancer. Br J Surg. 1999, 86: 1346-1348. 10.1046/j.1365-2168.1999.01212.x.CrossRefPubMed

Sauer T, Engh V, Holck AM, Sorpebol G, Heim M, Furu I, Schlichting E: Imprint cytology of sentinel lymph nodes in breast cancer. Experience with rapid, intraoperative diagnosis and primary screening by cytotechnologists. Acta Cytol. 2003, 47: 768-773.CrossRefPubMed

Koizumi M, Nomura E, Yamada Y, Takiguchi T, Tanaka K, Yoshimoto M, Makita M, Sakamoto G, Kasumi F, Ogata E: Sentinel node detection using 99mTc-rhenium sulphide colloid in breast cancer patients: evaluation of 1 day and 2 day protocols, and a dose-finding study. Nucl Med Commun. 2003, 24: 663-670. 10.1097/00006231-200306000-00008.CrossRefPubMed

10.

Koizumi M, Nomura E, Yamada Y, Takiguchi T, Makita M, Iwase T, Tada T, Tada K, Nishimura S, Takahashi K: Radioguided sentinel node detection in breast cancer patients: comparison of 99mTc phytate and 99mTc rhenium colloid efficacy. Nucl Med Commun. 2004, 25: 1031-1037. 10.1097/00006231-200410000-00007.CrossRefPubMed

11.

Zgajnar J, Frkovic-Grazio S, Besic N, Hocevar M, Vidergar-Kralj B, Gerljevic A, Pogacnik A: Low sensitivity of the touch imprint cytology of the sentinel lymph node in breast cancer patients--results of a large series. J Surg Oncol. 2004, 85: 82-86. 10.1002/jso.20011. discussion 87CrossRefPubMed

12.

Ravichandran D, Kocjan G, Falzon M, Ball RY, Ralphs DN: Imprint cytology of the sentinel lymph node in the assessment of axillary node status in breast carcinoma. Eur J Surg Oncol. 2004, 30: 238-242. 10.1016/j.ejso.2003.11.005.CrossRefPubMed

13.

Liang R, Craik J, Juhasz ES, Harman CR: Imprint cytology versus frozen section: intraoperative analysis of sentinel lymph nodes in breast cancer. ANZ J Surg. 2003, 73: 597-599. 10.1046/j.1445-2197.2003.02728.x.CrossRefPubMed

14.

Nagashima T, Suzuki M, Yagata H, Nikaido T, Horiuchi F, Koda K, Miyazaki M: Intraoperative cytologic diagnosis of sentinel node metastases in breast cancer. Acta Cytol. 2003, 47: 1028-1032.CrossRefPubMed

15.

Bochner MA, Farshid G, Dodd TJ, Kollias J, Gill PG: Intraoperative imprint cytologic assessment of the sentinel node for early breast cancer. World J Surg. 2003, 27: 430-432. 10.1007/s00268-002-6721-x.CrossRefPubMed

16.

Shiver SA, Creager AJ, Geisinger K, Perrier ND, Shen P, Levine EA: Intraoperative analysis of sentinel lymph nodes by imprint cytology for cancer of the breast. Am J Surg. 2002, 184: 424-427. 10.1016/S0002-9610(02)01003-6.CrossRefPubMed

17.

Van Diest PJ, Torrenga H, Borgstein PJ, Pijpers R, Bleichrodt RP, Rahusen FD, Meijer S: Reliability of intraoperative frozen section and imprint cytological investigation of sentinel lymph nodes in breast cancer. Histopathology. 1999, 35: 14-18. 10.1046/j.1365-2559.1999.00667.x.CrossRefPubMed

18.

Fisher CJ, Boyle S, Burke M, Price AB: Intraoperative assessment of nodal status in the selection of patients with breast cancer for axillary clearance. Br J Surg. 1993, 80: 457-458.CrossRefPubMed

19.

Leidenius MH, Krogerus LA, Toivonen TS, Von Smitten KJ: The feasibility of intraoperative diagnosis of sentinel lymph node metastases in breast cancer. J Surg Oncol. 2003, 84: 68-73. 10.1002/jso.10296.CrossRefPubMed

20.

Beach RA, Lawson D, Waldrop SM, Cohen C: Rapid immunohistochemistry for cytokeratin in the intraoperative evaluation of sentinel lymph nodes for metastatic breast carcinoma. Appl Immunohistochem Mol Morphol. 2003, 11: 45-50. 10.1097/00022744-200303000-00008.PubMed

21.

Viale G, Bosari S, Mazzarol G, Galimberti V, Luini A, Veronesi P, Paganelli G, Bedoni M, Orvieto E: Intraoperative examination of axillary sentinel lymph nodes in breast carcinoma patients. Cancer. 1999, 85: 2433-2438. 10.1002/(SICI)1097-0142(19990601)85:11<2433::AID-CNCR18>3.0.CO;2-3.CrossRefPubMed

22.

Leikola JP, Toivonen TS, Krogerus LA, von Smitten KA, Leidenius MH: Rapid immunohistochemistry enhances the intraoperative diagnosis of sentinel lymph node metastases in invasive lobular breast carcinoma. Cancer. 2005, 104: 14-19. 10.1002/cncr.21133.CrossRefPubMed

Title: Frozen section is superior to imprint cytology for the intra-operative assessment of sentinel lymph node metastasis in Stage I Breast cancer patients
Authors: Miki Mori
Keiichiro Tada
Motoko Ikenaga
Yumi Miyagi
Seiichiro Nishimura
Kaoru Takahashi
Masujiro Makita
Takuji Iwase
Fujio Kasumi
Mituru Koizumi
Publication date: 01-12-2006
Publisher: BioMed Central
Published in: World Journal of Surgical Oncology / Issue 1/2006
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/1477-7819-4-26

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Frozen section is superior to imprint cytology for the intra-operative assessment of sentinel lymph node metastasis in Stage I Breast cancer patients

Abstract

Background

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusion

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