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Intraoperative touch preparation for sentinel lymph node biopsy: A 4-year experience

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Abstract

Background

The optimal technique for intraoperative pathologic examination of sentinel lymph nodes (SLNs) is still controversial. Recent small series report sensitivity between 60% and 100% for various techniques. The aim of this study was to evaluate our long-term experience with touch preparation cytology (TPC) and frozen section (FS) in the intraoperative examination of SLNs for breast cancer.

Methods

A total of 247 patients with operable breast cancer underwent an SLN biopsy for staging of the axilla. The SLN was identified by99mTc-labeled sulfur colloid unfiltered dye, blue dye, or both and dissected, and then intraoperative TPC or FS and permanent section, or both, were performed.

Results

A total of 479 SLNs were submitted for TPC and permanent hematoxylin and eosin. A total of 68 SLNs were positive by hematoxylin and eosin; 65 SLNs were positive by TPC, with a false-negative rate of 5.8%. The sensitivity for TPC was 94.2%, with a false-positive rate of 0.2%. A total of 165 SLNs were submitted for FS, with a sensitivity of 85.7% and a specificity of 98.6%. The false-positive rate was 1.4%, with a false-negative rate of 15.8%.

Conclusions

In a large series, TPC is as accurate as FS but is simpler and faster in the detection of intraoperative metastasis in SLNs for breast cancer.

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References

  1. Krag DN, Ashikaga T, Harlow SP, Weaver DL. Development of sentinel node targeting technique in breast cancer patients.Breast J 1998;4:67–74.

    Article  Google Scholar 

  2. Borgstein PJ, Pijpers R, Comans EF, van Diest PJ, Boom RP, Meijer S. Sentinel lymph node biopsy in breast cancer: guidelines and pitfalls of lymphoscintigraphy and gamma probe detection.J Am Coll Surg 1998;186:275–83.

    Article  PubMed  CAS  Google Scholar 

  3. Krag D Weaver D, Ashikaga T, et al. The sentinel node in breast cancer: a multicenter validation study.N Engl J Med 1998;339: 941–6.

    Article  PubMed  CAS  Google Scholar 

  4. Rubio IT, Korourian S, Cowan C, Krag DN, Colvert M, Klimberg VS. Sentinel lymph node biopsy for staging breast cancer.Am J Surg 1998;176:532–7.

    Article  PubMed  CAS  Google Scholar 

  5. Veronesi U, Paganelli G, Viale G, et al. Sentinel lymph node biopsy and axillary dissection in breast cancer: results in a large series.J Natl Cancer Inst 1999;91:368–73.

    Article  PubMed  CAS  Google Scholar 

  6. Giuliano AE, Jones RC, Brennan M, Statman R. Sentinel lymphadenectomy in breast cancer.J Clin Oncol 1997;15:2345–50.

    PubMed  CAS  Google Scholar 

  7. Guenther JM, Krishnamoorthy M, Tan LR. Sentinel lymphadenectomy for breast cancer in a community managed care setting.Cancer J Sci Am 1997;3:336–40.

    PubMed  CAS  Google Scholar 

  8. Klimberg VS, Rubio IT, Henry-Tillman R, Cowan C, Colvert M, Korourian S. Subareolar versus peritumoral injection for location of the sentinel lymph node.Ann Surg 1999;229:860–4; discussion, 864-5.

    Article  PubMed  CAS  Google Scholar 

  9. Kern KA. Sentinel lymph node mapping in breast cancer using subareolar injection of blue dye.J Am Coll Surg 1999;189:539–45.

    Article  PubMed  CAS  Google Scholar 

  10. Morrow M, Rademaker AW, Bethke KP, et al. Learning sentinel node biopsy: results of a prospective randomized trial of two techniques.Surgery 1999;126:714–22.

    PubMed  CAS  Google Scholar 

  11. Borgstein PJ, Meijer S, Pijpers R. Intradermal blue dye to identify sentinel lymph node in breast cancer.Lancet 1997;349:1668–9.

    Article  PubMed  CAS  Google Scholar 

  12. O’Hea BJ, Hill ADK, El-Shirbiny A, et al. Sentinel lymph node biopsy in breast cancer: initial experience at Memorial Sloan-Kettering Cancer Center.J Am Coll Surg 1998;186:423–7.

    Article  PubMed  CAS  Google Scholar 

  13. Quill DS, Leahy AL, Lawler RG, Finney RD. Lymph node imprint cytology for the rapid assessment of axillary node metastases in breast cancer.Br J Surg 1984;71:454–5.

    Article  PubMed  CAS  Google Scholar 

  14. Rubio IT, Korourian S, Cowan C, Krag DN, Colvert M, Klimberg VS. Use of touch preps for intraoperative diagnosis of sentinel lymph node metastases in breast cancer.Ann Surg Oncol 1998;5:689–94.

    Article  PubMed  CAS  Google Scholar 

  15. 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; 86:1346–9.

    Article  PubMed  CAS  Google Scholar 

  16. 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;87:597–601.

    Article  PubMed  CAS  Google Scholar 

  17. Flett MM, Going JJ, Stanton PD, Cooke TG. Sentinel node localization in patients with breast cancer.Br J Cancer 1998;85:991–3.

    CAS  Google Scholar 

  18. Veronesi U, Paganelli G, Galimberti V, et al. Sentinel node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph-nodes.Lancet 1997;349:1864–7.

    Article  PubMed  CAS  Google Scholar 

  19. Turner RR, Hansen NM, Stern SL, Giuliano AE. Intraoperative examination of the sentinel lymph node for breast carcinoma staging.Am J Clin Pathol 1999;112:627–34.

    PubMed  CAS  Google Scholar 

  20. 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;7:651–5.

    Article  PubMed  CAS  Google Scholar 

  21. Ku NNK, Ahmad N, Smith PV, et al. Intraoperative imprint cytology of sentinel lymph nodes in breast cancer.Acta Cytol 1997;41:1606–7.

    Google Scholar 

  22. Greenberg RS.Medical Epidemiology, Norwalk, CT: Appleton & Lange, 1993.

    Google Scholar 

  23. Dudgeon LS, Patrick CV. A new method for the rapid microscopical diagnosis of tumors: with an account of 200 cases examined.Br J Surg 1927;15:250–61.

    Article  Google Scholar 

  24. Morris DL, Moore J, Thompson H, Keighley MRB. Preoperative lymph node imprint cytology for staging gastric carcinoma (abstract).Br J Surg 1982;69:282.

    Google Scholar 

  25. van Diest PJ, Peterse HL, Borgstein PJ, Hoekstra O, Meijer C. Pathological investigation of sentinel lymph nodes.Eur J Nucl Med 1999;26(Suppl):S43–9.

    Article  Google Scholar 

  26. Weaver DL, Krag DN, Ashikaga T, Harlow SP, O’Connell M. Pathologic analysis of sentinel and nonsentinel lymph nodes in breast carcinoma (a multicenter study).Cancer 2000;88:1099–107.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Fashion Footwear Association of New York/Virginia Clinton Kelley Research Fellowship, 4301 West Markham, Slot 725, 72205, Little Rock, Arkansas

    Anita T. Johnson MD & LaNette F. Smith MD

  2. Department of Veterans Affairs, Central Arkansas Veterans Healthcare System, University of Arkansas for Medical Sciences, Arkansas Cancer Research Center, 4301 West Markham, Slot 725, 72205, Little Rock, Arkansas

    Ronda S. Henry-Tillman MD, Isabel T. Rubio MD, Anita T. Johnson MD, Anne T. Mancino MD, LaNette F. Smith MD, Kent C. Westbrook MD & V. Suzanne Klimberg MD

  3. Department of Surgery, 4301 West Markham, Slot 725, 72205, Little Rock, Arkansas

    Ronda S. Henry-Tillman MD, Isabel T. Rubio MD, Anita T. Johnson MD, Anne T. Mancino MD, LaNette F. Smith MD, Kent C. Westbrook MD & V. Suzanne Klimberg MD

  4. Department of Pathology, 4301 West Markham, Slot 725, 72205, Little Rock, Arkansas

    Soheila Korourian MD, Nicole Massol MD & V. Suzanne Klimberg MD

Authors
  1. Ronda S. Henry-Tillman MD
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  2. Soheila Korourian MD
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  3. Isabel T. Rubio MD
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  4. Anita T. Johnson MD
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  5. Anne T. Mancino MD
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  6. Nicole Massol MD
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  7. LaNette F. Smith MD
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  8. Kent C. Westbrook MD
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  9. V. Suzanne Klimberg MD
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Corresponding author

Correspondence to Ronda S. Henry-Tillman MD.

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Henry-Tillman, R.S., Korourian, S., Rubio, I.T. et al. Intraoperative touch preparation for sentinel lymph node biopsy: A 4-year experience. Annals of Surgical Oncology 9, 333–339 (2002). https://doi.org/10.1007/BF02573867

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  • DOI: https://doi.org/10.1007/BF02573867

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