Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2008

01-06-2008 | Breast Oncology

Intraoperative Frozen Section Analysis of Sentinel Lymph Node in Breast Cancer Patients Treated with Neoadjuvant Chemotherapy

Authors: Kenzo Shimazu, MD, Yasuhiro Tamaki, MD, Tetsuya Taguchi, MD, Fumine Tsukamoto, MD, Tsutomu Kasugai, MD, Shinzaburo Noguchi, MD

Published in: Annals of Surgical Oncology | Issue 6/2008

Login to get access

Abstract

Background

Recently, many studies have demonstrated the feasibility and accuracy of sentinel lymph node (SLN) biopsy for patients treated with neoadjuvant chemotherapy (NAC). However, no studies have been conducted to evaluate the accuracy of frozen section (FS) analysis of SLN in NAC-treated patients. The aim was to evaluate the accuracy of intraoperative FS analysis of SLNs in breast cancer patients treated with NAC in comparison with that in those not treated.

Methods

Patients with primary breast cancer either treated with NAC (n = 62) or not treated (n = 301) were included in this study. Intraoperatively, the largest cut surface (2-mm thickness) of the SLN was subjected to FS analysis. Remainders of the SLN were formalin-fixed, serially sectioned at 2-mm thickness, and subjected to H&E staining and immunohistochemistry. The largest diameter of metastases in the SLN was measured.

Results

The sensitivity, specificity, and accuracy of FS analysis of SLNs were 74, 100, and 88%, respectively, for NAC-treated patients, similar to the corresponding values of 71, 99, and 90% for non-NAC-treated patients. The sensitivity of FS analysis for macrometastases was lower for NAC-treated patients (76%) than for non-NAC-treated patients (91%), while that for micrometastases and isolated tumor cells was higher for NAC-treated patients (67%) than for non-NAC-treated patients (31%). However, neither of these differences was statistically significant.

Conclusions

Intraoperative FS analysis of SLNs is as accurate for NAC-treated as for non-NAC-treated patients, indicating that FS analysis of SLNs is a clinically acceptable method for those receiving NAC.
Literature
1.
Veronesi U, Paganelli G, Viale G, et al. Sentinel-lymph-node biopsy as a staging procedure in breast cancer: update of a randomized controlled study. Lancet Oncol 2006;7:983–90PubMedCrossRef
2.
Veronesi U, Paganelli G, Viale G, et al. A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med 2003;349:546–53PubMedCrossRef
3.
Giuliano AE, Haigh PI, Brennan MB, et al. Prospective observational study of sentinel lymphadenectomy without further axillary dissection in patients with sentinel node-negative breast cancer. J Clin Oncol 2000;18:2553–9PubMed
4.
Weiser MR, Montgomery LL, Susnik B, et al. Is routine intraoperative frozen-section examination of sentinel lymph nodes in breast cancer worthwhile? Ann Surg Oncol 2000;7:651–5PubMedCrossRef
5.
Chao C, Wong SL, Ackermann D, et al. Utility of intraoperative frozen section analysis of sentinel lymph nodes in breast cancer. Am J Surg 2001;182:609–15PubMedCrossRef
6.
Tanis PJ, Boom RP, Koops HS, et al. Frozen section investigation of the sentinel node in malignant melanoma and breast cancer. Ann Surg Oncol 2001;8:222–6PubMedCrossRef
7.
Gulec SA, Su J, O’Leary JP, et al. Clinical utility of frozen section in sentinel node biopsy in breast cancer. Am Surg 2001;67:529–32PubMed
8.
Wada N, Imoto S, Hasebe T, et al. Evaluation of intraoperative frozen section diagnosis of sentinel lymph nodes in breast cancer. Jpn J Clin Oncol 2004;34:113–7PubMedCrossRef
9.
Fortunato L, Amini M, Farina M, et al. Intraoperative examination of sentinel nodes in breast cancer: is the glass half full or half empty? Ann Surg Oncol 2004;11:1005–10PubMedCrossRef
10.
Motomura K, Inaji H, Komoike Y, et al. Intraoperative sentinel lymph node examination by imprint cytology and frozen sectioning during breast surgery. Br J Surg 2000;87:597–601PubMedCrossRef
11.
Xing Y, Foy M, Cox DD, et al. Meta-analysis of sentinel lymph node biopsy after preoperative chemotherapy in patients with breast cancer. Br J Surg 2006;93:539–46PubMedCrossRef
12.
Mamounas EP, Brown A, Anderson S, et al. Sentinel node biopsy after neoadjuvant chemotherapy in breast cancer: results from National Surgical Adjuvant Breast and Bowel Project Protocol B-27. J Clin Oncol 2005;23:2694–702PubMedCrossRef
13.
Shimazu K, Tamaki Y, Taguchi T, et al. Sentinel lymph node biopsy using periareolar injection of radiocolloid for patients with neoadjuvant chemotherapy-treated breast carcinoma. Cancer 2004;100:2555–61PubMedCrossRef
14.
Tanaka Y, Maeda H, Ogawa Y, et al. Sentinel node biopsy in breast cancer patients treated with neoadjuvant chemotherapy. Oncol Rep 2006;15:927–31PubMed
15.
Kinoshita T, Takasugi M, Iwamoto E, et al. Sentinel lymph node biopsy examination for breast cancer patients with clinically negative axillary lymph nodes after neoadjuvant chemotherapy. Am J Surg 2006;191:225–9PubMedCrossRef
16.
Miller AR, Thomason VE, Yeh IT, et al. Analysis of sentinel lymph node mapping with immediate pathologic review in patients receiving preoperative chemotherapy for breast carcinoma. Ann Surg Oncol 2002;9:243–7PubMed
17.
Breslin TM, Cohen L, Sahin A, et al. Sentinel lymph node biopsy is accurate after neoadjuvant chemotherapy for breast cancer. J Clin Oncol 2000;18:3480–6PubMed
18.
Stearns V, Ewing CA, Slack R, et al. Sentinel lymphadenectomy after neoadjuvant chemotherapy for breast cancer may reliably represent the axilla except for inflammatory breast cancer. Ann Surg Oncol 2000;9:235–42CrossRef
19.
Haid A, Tausch C, Lang A, et al. Is sentinel lymph node biopsy reliable and indicated after preoperative chemotherapy in patients with breast carcinoma? Cancer 2001;92:1080–4PubMedCrossRef
20.
Julian TB, Dusi D, Wolmark N. Sentinel node biopsy after neoadjuvant chemotherapy for breast cancer. Am J Surg 2002; 184:315–7PubMedCrossRef
21.
Tafra L, Verbanac KM, Lannin DR. Preoperative chemotherapy and sentinel lymphadenectomy for breast cancer. Am J Surg 2001;182:312–5PubMedCrossRef
22.
Aihara T, Munakata S, Morino H, et al. Feasibility of sentinel node biopsy for breast cancer after neoadjuvant endocrine therapy: a pilot study. J Surg Oncol 2004;85:77–81PubMedCrossRef
23.
Shimazu K, Tamaki Y, Taguchi T, et al. Lymphoscintigraphic visualization of internal mammary nodes with subtumoral injection of radiocolloid in patients with breast cancer. Ann Surg 2003;237:390–8PubMedCrossRef
24.
Shimazu K, Tamaki Y, Taguchi T, et al. Comparison between periareolar and peritumoral injection of radiotracer for sentinel lymph node biopsy in patients with breast cancer. Surgery 2002;131:277–86PubMedCrossRef
25.
Singletary SE, Allred C, Ashley P, et al. Revision of the American Joint Committee on Cancer Staging System for breast cancer. S Clin Oncol 2002;20:3628–36CrossRef
26.
Fisher ER, Wang J, Bryant J, et al. Pathobiology of preoperative chemotherapy: findings from the National Surgical Adjuvant Breast and Bowel (NSABP) protocol B-18. Cancer 2002;95:681–95PubMedCrossRef
27.
Honkoop AH, Pinedo HM, De Jong JS, et al. Effects of chemotherapy on pathologic and biologic characteristics of locally advanced breast cancer. Am J Clin Pathol 1997;107:211–8PubMed
28.
Ryden L, Chebil G, Sjostrom L, et al. Determination of sentinel lymph node (SLN) status in primary breast cancer by prospective use of immunohistochemistry increases the rate of micrometastases and isolated tumour cells: analysis of 174 patients after SLN biopsy. Eur J Surg Oncol 2007;33:33–8PubMedCrossRef
Metadata
Title
Intraoperative Frozen Section Analysis of Sentinel Lymph Node in Breast Cancer Patients Treated with Neoadjuvant Chemotherapy
Authors
Kenzo Shimazu, MD
Yasuhiro Tamaki, MD
Tetsuya Taguchi, MD
Fumine Tsukamoto, MD
Tsutomu Kasugai, MD
Shinzaburo Noguchi, MD
Publication date
01-06-2008
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 6/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-008-9831-3

Other articles of this Issue 6/2008

Annals of Surgical Oncology 6/2008 Go to the issue

Breast Oncology

Staging of Invasive Breast Carcinoma Patients With T4anyNM0 and T1–3N3M0

Endocrine Tumors

The Influence of Surgical Approach on Quality of Life After Parathyroid Surgery

Melanomas

Criteria in Sentinel Lymph Nodes of Melanoma Patients that Predict Involvement of Nonsentinel Lymph Nodes

Thoracic Oncology

Surgical Treatment in the Management of Malignant Pleural Mesothelioma: A Single Institution’s Experience

Breast Oncology

Stage IIIC Breast Carcinoma and Prognostically Different Subgroups

Gastrointestinal Oncology

Esophageal Cancers with Synchronous or Antecedent Head and Neck Cancers: A More Formidable Challenge?