Factors influencing accuracy of axillary sentinel lymph node frozen section for breast cancer

Amariek J. Jensen, Arpana Naik, Rodney Pommier, John Vetto, Megan Troxell

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: Intraoperative sentinel lymph node (SLN) frozen section (FS) guides immediate axillary lymph node dissection in breast cancer patients. Methods: The Oregon Health & Science University pathology database was searched for SLN FS From October 1999 to January 1, 2009. Slides of positive cases were reviewed and metastasis sizes measured. Results: Of 416 cases, 129 were positive (31%) on permanent sections and immunohistochemistry, with 79 concordant and 50 false-negative FS. Accuracy was 88%, sensitivity 61%, and specificity 100%. FS accuracy for lobular carcinoma (76%) was lower than for invasive ductal carcinoma (88%) (P = .048). FS accuracy significantly differed by size of nodal tumor. For 49 cases of tumor ≤ 2 mm (isolated tumor cells plus micrometastases), the accuracy of FS was 18%; for 77 cases of >2-mm metastases, accuracy was 90% (P <.0001). Conclusions: False-negative FS were predominantly small nodal tumor deposits not sampled at FS. Although accuracy was lower, SLN FS is still beneficial in lobular carcinoma, but not ductal carcinoma in situ.

Original languageEnglish (US)
Pages (from-to)629-635
Number of pages7
JournalAmerican Journal of Surgery
Volume199
Issue number5
DOIs
StatePublished - May 2010

Fingerprint

Frozen Sections
Breast Neoplasms
Lobular Carcinoma
Neoplasms
Neoplasm Metastasis
Sentinel Lymph Node
Neoplasm Micrometastasis
Ductal Carcinoma
Carcinoma, Intraductal, Noninfiltrating
Lymph Node Excision
Immunohistochemistry
Databases
Pathology
Sensitivity and Specificity
Health

Keywords

  • Axillary lymph node dissection
  • Breast cancer
  • Frozen section
  • Micrometastasis
  • Sentinel lymph node

ASJC Scopus subject areas

  • Surgery

Cite this

Factors influencing accuracy of axillary sentinel lymph node frozen section for breast cancer. / Jensen, Amariek J.; Naik, Arpana; Pommier, Rodney; Vetto, John; Troxell, Megan.

In: American Journal of Surgery, Vol. 199, No. 5, 05.2010, p. 629-635.

Research output: Contribution to journalArticle

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abstract = "Background: Intraoperative sentinel lymph node (SLN) frozen section (FS) guides immediate axillary lymph node dissection in breast cancer patients. Methods: The Oregon Health & Science University pathology database was searched for SLN FS From October 1999 to January 1, 2009. Slides of positive cases were reviewed and metastasis sizes measured. Results: Of 416 cases, 129 were positive (31{\%}) on permanent sections and immunohistochemistry, with 79 concordant and 50 false-negative FS. Accuracy was 88{\%}, sensitivity 61{\%}, and specificity 100{\%}. FS accuracy for lobular carcinoma (76{\%}) was lower than for invasive ductal carcinoma (88{\%}) (P = .048). FS accuracy significantly differed by size of nodal tumor. For 49 cases of tumor ≤ 2 mm (isolated tumor cells plus micrometastases), the accuracy of FS was 18{\%}; for 77 cases of >2-mm metastases, accuracy was 90{\%} (P <.0001). Conclusions: False-negative FS were predominantly small nodal tumor deposits not sampled at FS. Although accuracy was lower, SLN FS is still beneficial in lobular carcinoma, but not ductal carcinoma in situ.",
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