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Sentinel Node Positivity Rates With and Without Frozen Section for Breast Cancer

  • Breast Oncology
  • Original Paper
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Sentinel lymph node biopsy (SLNB) is used to detect breast cancer axillary metastases. Some surgeons send the sentinel lymph node (SLN) for intraoperative frozen section (FS) to minimize delayed axillary dissections. There has been concern that FS may discard nodal tissue and thus underdiagnose small metastases. This study examines whether evaluation of SLN by FS increases the false-negative rate of SLNB.

Methods

A retrospective analysis of SLNB from 659 patients was conducted to determine the frequency of node positivity among SLNB subjected to both FS and permanent section (PS) versus PS alone. Statistical analysis was performed by the χ2 square test, and a logistic regression model was applied to estimate the effect of final node positivity between the two groups.

Results

FS was performed in 327 patients and PS was performed in all 659 patients. Among patients undergoing both FS and PS (n = 327), the final node positivity rate was 33.0% compared with 19.6% among patients undergoing PS alone (n = 332). After adjustment for patient age, tumor diameter, grade, and hormone receptor status in a multivariate logistic regression model, there remained an increased likelihood of final node positivity for patients undergoing both procedures relative to PS alone (adjusted odds ratio, 2.1; 95% confidence interval, 1.3–3.6; P = .005).

Conclusions

There was a higher rate of SLN positivity in specimens evaluated by both FS and PS. Therefore, evaluating SLN by FS does not underdiagnose small metastases nor produce a higher false-negative rate. Intraoperative FS offers the advantage of less delayed axillary dissections.

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Acknowledgments

We thank the following medical students for their assistance in data collection: Erika Moseson, John Pilavas, Maryam Shafee, Jessica Cataldi, and Alison Colantino. Supported by Dancers Care Foundation.

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Authors and Affiliations

  1. Department of Surgery, Weill Medical College of Cornell University, 525 E. 68th St., New York, NY, 10065, USA

    Nimmi Arora MD, Diana Martins PA, Tara L. Huston MD, Michael P. Osborne MD, Alexander J. Swistel MD, Eleni Tousimis MD, Peter I. Pressman MD & Rache M. Simmons MD

  2. Department of Biostatistics and Epidemiology, Weill Medical College of Cornell University, 525 E. 68th St., New York, NY, 10065, USA

    Paul Christos BA

  3. Department of Pathology, Weill Medical College of Cornell University, 525 E. 68th St., New York, NY, 10065, USA

    Syed Hoda MD

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  1. Nimmi Arora MD
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  2. Diana Martins PA
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  3. Tara L. Huston MD
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  8. Eleni Tousimis MD
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  9. Peter I. Pressman MD
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  10. Rache M. Simmons MD
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Correspondence to Rache M. Simmons MD.

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Arora, N., Martins, D., Huston, T.L. et al. Sentinel Node Positivity Rates With and Without Frozen Section for Breast Cancer. Ann Surg Oncol 15, 256–261 (2008). https://doi.org/10.1245/s10434-007-9600-8

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  • DOI: https://doi.org/10.1245/s10434-007-9600-8

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