Annals of Surgical Oncology

, Volume 8, Issue 10, pp 817–820

The Problem of the Accuracy of Intraoperative Examination of Axillary Sentinel Nodes in Breast Cancer

Authors

    • Department of SenologyUniversity of Milan School of Medicine, European Institute of Oncology
    • Scientific Director’s OfficeEuropean Institute of Oncology
  • Giovanni Mazzarol
    • Department of Pathology and Laboratory MedicineUniversity of Milan School of Medicine, European Institute of Oncology
  • Viviana Galimberti
    • Department of SenologyUniversity of Milan School of Medicine, European Institute of Oncology
  • Giuseppe Renne
    • Department of Pathology and Laboratory MedicineUniversity of Milan School of Medicine, European Institute of Oncology
  • Fabio Bassi
    • Department of SenologyUniversity of Milan School of Medicine, European Institute of Oncology
  • Franco Iafrate
    • Department of SenologyUniversity of Milan School of Medicine, European Institute of Oncology
  • Giuseppe Viale
    • Department of Pathology and Laboratory MedicineUniversity of Milan School of Medicine, European Institute of Oncology
Article

DOI: 10.1007/s10434-001-0817-7

Cite this article as:
Zurrida, S., Mazzarol, G., Galimberti, V. et al. Ann Surg Oncol (2001) 8: 817. doi:10.1007/s10434-001-0817-7

Abstract

Background: Sentinel node SN biopsy has become accepted as a reliable method of predicting the state of the axilla in breast cancer. The key issue, however, is the accuracy of the pathological evaluation of the biopsied node, which should be done intraoperatively whenever possible.

Methods: In our initial experience on 192 patients using a conventional intraoperative frozen section method, the false-negative rate was 6.3%, and the negative predictive value was 93.7%. We devised a new and exhaustive intraoperative method, requiring about 40 minutes, in which pairs of sections are taken every 50 μ for the first 15 sections and every 100 μ thereafter, sampling the entire node. Sentinel node metastases were found in 143 of the 376 T1N0 cases examined 38%.

Results: Metastases were always identified on hematoxylin and eosin sections, although in 4% of cases, cytokeratin immunostaining on adjacent sections was useful for confirming malignancy. In 233 patients the SNs were disease-free; of these patients, 222 had metastasis-free axillary nodes, and 11 4.7% had another metastatic node.

Conclusion: Extensive intraoperative examination of frozen sentinel nodes correctly predicts an uninvolved axilla in 95.3% of cases negative predictive value. This method is, therefore, suitable for identifying patients in whom axillary dissection can be avoided.

Copyright information

© The Society of Surgical Oncology, Inc. 2001