Document Detail

Value of intraoperative examination of axillary sentinel nodes in carcinoma of the breast.
MedLine Citation:
PMID:  18954790     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The value of frozen sections in the intraoperative examination of sentinel nodes (SN) remains controversial. Accurate frozen sections will spare those patients with node metastasis from a second procedure to complete the axillary dissection. We examined our own experience with intraoperative examination of SN. STUDY DESIGN: Between January 1, 2006, and December 31, 2006, we performed 236 sentinel lymph node biopsy procedures that were read as "frozen-section-negative." An additional 47 sentinel lymph node biopsy patients were frozen-section-positive for metastatic disease and underwent immediate completion axillary dissection. At least 1 SN was found in all 283 women (100%). The number of patients with false-negative frozen sections was tallied; patient data were reviewed for a number of variables to see which factors might be associated with a false-negative result. RESULTS: Eleven patients had positive nodes on subsequent examination of the formalin-fixed, hematoxylin and eosin-stained slides; the false-negative rate of intraoperative frozen section was 4.7%. The sensitivity of the negative frozen section was > 95%. The following variables were compared for significance: pathologist, nuclear grade, histologic grade, margins, lymphovascular invasion, tumor type (ductal versus lobular), and estrogen receptor and progesterone receptor values. The only significant variables were lymphovascular invasion (p = 0.019) and presence of in situ ductal carcinoma (p = 0.001). CONCLUSIONS: Our data confirm the value of intraoperative examination of SN: > 95% sensitivity. Presence of in situ ductal carcinoma or lymphovascular invasion makes these tumors more likely than others to have micrometastases to SN overlooked.
Gordon F Schwartz; Lauren S Krill; Juan P Palazzo; Abhijit Dasgupta
Publication Detail:
Type:  Journal Article     Date:  2008-08-23
Journal Detail:
Title:  Journal of the American College of Surgeons     Volume:  207     ISSN:  1879-1190     ISO Abbreviation:  J. Am. Coll. Surg.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-28     Completed Date:  2008-11-18     Revised Date:  2009-05-21    
Medline Journal Info:
Nlm Unique ID:  9431305     Medline TA:  J Am Coll Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  758-62     Citation Subset:  AIM; IM    
Department of Surgery, Jefferson Medical College, Philadelphia, PA 19107, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Aged, 80 and over
Breast Neoplasms / pathology*,  surgery*
Carcinoma / secondary*,  surgery*
Cohort Studies
False Negative Reactions
Frozen Sections*
Middle Aged
Predictive Value of Tests
Retrospective Studies
Sentinel Lymph Node Biopsy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Chylous ascites after pancreaticoduodenectomy: introduction of a grading system.
Next Document:  Surgical-office-based versus radiology-referral-based breast ultrasonography: a comparison of effici...