Achieving Breast Cancer Surgery in a Single Setting With Intraoperative Frozen Section Analysis of the Sentinel Lymph Node

Lu, Qinghui; Tan, Elaine; Ho, Bernard; Teo, C. J.; Seah, M; Chen, Juliana J. C.; Chan, Peter

doi:10.1016/j.clbc.2012.11.005

Cited by 16 publications

(18 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other researches still recommend intraoperative assessment of SNs. For clinical node negative breast cancer, intraoperative frozen section has a sensitivity of 87%, specificity of 100%, and a patient recall rate of 3% [15]. Risk factors of FNSN include tumor location, lymphovascular invasion, suspicious node in preoperative study, less than three SNs, invasive lobular carcinoma, and poorly-differentiated cancer [23,24].…”

Section: Discussionmentioning

confidence: 99%

“…Intraoperative frozen section of SNs has a sensitivity of 87% and a specificity of 100%. Estimated 3% patients are recalled for ALND due to a false negative result of frozen section during the first operation [15]. Number of SNs is also a confounding factor of false negative results of SLNB and harvesting only one sentinel node contributes higher rate of axillary recurrence [16].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Non-Inferiority of Survival in Early Breast Cancer Patients with False-Negative Sentinel Nodes After Completing Axillary Lymph Node Dissection

Loh

Lee

Chen

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Sentinel lymph node biopsy (SLNB) is standard approach of axillary region for early breast cancer patients with clinically negative node. The present study investigated patients with false-negative sentinel nodes (FNSN) of intraoperative frozen section.Methods A case-control study with 1:3 ratio was conducted. FNSN was diagnosed as negative sentinel nodes (SNs) in frozen sections, but positive for metastasis in formalin-fixed paraffin-embedded (FFPE) blocks. Control was defined no metastasis of SNs in both frozen and FFPE sections.Results Total 20 FNSN cases and 60 matched-controls were enrolled from 333 SLNB patients between April 1, 2005 and November 31, 2009. The demographics and intrinsic subtypes of breast cancer were similar between FNSN and controls. The FNSN patients had a larger tumor size in preoperative mammography and more lymphatic tumor emboli in core biopsy (P-value 0.033 and < 0.001, respectively). Four FNSN patients had metastasis in the non-relevant SNs. Other 16 FNSN patients had results of benign lymphoid hyperplasia of SNs in frozen sections and metastasis in FFPE blocks. Micrometastasis (less than 2 mm) was detected in seven of 16 patients and metastases in non-sentinel nodes was recognized in two of 16 patients. All FNSN patients received second operation with axillary lymph node dissection (ALND). After a median follow-up of 143 months, no FNSN patients developed recurrence of breast cancer. The disease-free survival, disease-specific survival, and overall survival in FNSN were non-inferior than controls.Conclusion Outcomes of FNSN patients after completing ALND was non-inferior to those without metastasis in SNs. ALND improved survival of patients with metastasis non-sentinel ALNs. However, omitting ALND had no effect for those have only micrometastasis in SNs.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Non-Inferiority of Survival in Early Breast Cancer Patients with False-Negative Sentinel Nodes After Completing Axillary Lymph Node Dissection

Loh

Lee

Chen

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Несмотря на эти недостатки, метод фиксации срезов путем замораживания часто является более предпочтительным для интраоперационной оценки СЛУ. Чувствительность данного метода составляет 52-93%, а специфичность 98.5-100% [15][16]. Мета-анализ 47 исследований замороженных срезов СЛУ, показал общую чувствительность как 73%, с более высокой чувствительностью для макрометастазов, чем для микрометастазов (94% против 40%) [17].…”

Section: интраоперационная оценка сигнальных лимфатических узлов (слу)unclassified

The role of sentinel lymph nodes in breast cancer. The current state of the problem.

2017

View full text Add to dashboard Cite

Sentinel lymph nodes (SLN) biopsy is currently the standard procedure for axillary staging in patients with invasive breast cancer and clinically negative lymph nodes (cN0). Historically, all patients with a positive sentinel lymph node (SLN) undergo classical axillary lymph node dissection (ALND). A randomized clinical trial in patients with breast cancer with clinical T1-2N0M0, with positive SLN afterwards undergo classical ALND showed that women diagnosed with T1-T2 and cN0 who underwent breast-conserving surgery and radiation therapy can safely avoid ALND. The main goal of SLN examination should be the detection of all macrometastases (> 2 mm). The role and timing of SLN in patients who received neoadjuvant polychemotherapy is still controversial and continues being studied in clinical trials.Keywords: breast cancer -sentinel lymph node -axillary lymphadenectomy. ТҰЖЫРЫМДАМАБүгінгі таңда сүт безінің қатерлі ісігімен және клиникалық теріс лимфа түйіндерімен ауыратын науқастарға сигналды лимфатикалық түйіндердің биопсиясын (СЛТБ) жүргізу стандартты рәсім болып табылады. Тарихқа жүгінсек, оң сигналды лимфотүйіндері (ОСЛ) бар барлық науқастар классикалық аксилярлы лимфодиссекцияга (АЛД) ұшырайды. T1-2N0M0 клиникасымен жүретін, соңында оң ОСЛ бар, классикалы лимфодиссекцияға үшырайтын (ACOSOG Z0011) сүт бездерінің қатерлі ісіктерінің рандомизирленген клинкалық зерттеулері T1-T2 және СN0 диагнозымен ағзаны сақтап қалушы және сәулелі терапия жүргізілген әйелдер САЛД-дан қауіпсіз құтылса болады. БСЛУ-дың негізгі мақсаты болып барлық макрометастаздарды табу болып келеді (> 2 мм). Неоадьювантты полихимиотерапияны(НАПХТ) қабылдаған науқастарға уақытша БСЛУ жүргізудің маңызы және мерзімі даулы болып келеді, және де әдеттегідей клиникалық сынауларда зерттелуде.Маңызды сөздер: сүт безінің қатерлі ісігі -сигналды лимфатикалық түйін -аксилярлы лимфодиссекция. РОЛЬ СИГНАЛЬНЫХ ЛИМФАТИЧЕСКИХ УЗЛОВ ПРИ РАКЕ МОЛОЧНОЙ ЖЕЛЕЗЫ. СОВРЕМЕННОЕ СОСТОЯ- РЕЗЮМЕБиопсия сигнальных лимфатических узлов (БСЛУ) на сегодняшний день является стандартной процедурой стадирования у боль-ных с инвазивным раком молочной железы и клинически негативными лимфоузлами (сN0). Исторически так сложилось, что все пациенты с положительным сигнальным лимфоузлом (СЛУ) подвергаются классической аксиллярной лимфодиссекции (АЛД). Рандомизированное клиническое исследование у больных раком молочной железы с клиническим T1-2N0M0, с позитивными СЛУ в последствии, подвергшихся классической АЛД (ACOSOG Z0011) показало, что женщины с диагнозом T1-T2 и сN0, которым проведена органосохраняющая операция и лучевая терапия может безопасно избежать АЛД. Основной целью БСЛУ должно быть обнаружение всех макрометастазов (> 2 мм). Роль и временные сроки проведения БСЛУ у пациентов, которые получили неоадъювантную полихимиотерапию (НАПХТ) является пока спорным, и по-прежнему изучаются в клинических испытаниях. Биоматериал СЛУ, полученный от пациентов с инвазивным раком молочной железы, прошедших неоадъювантную химиотерапию создают некоторые трудности для патологоанатомов.Кл...

show abstract

“…Despite these disadvantages, FS is often the preferred method for IOE of most histopathologists. The sensitivity of SLN FS is 52–93%, and the specificity is 98.5–100% . A meta‐analysis, including 47 FS studies, reported a pooled sensitivity of 73%, with higher sensitivity for macrometastases than for micrometastases (94% versus 40%) .…”

Section: Intraoperative Evaluation (Ioe) Of Slnsmentioning

confidence: 99%

Sentinel lymph nodes for breast carcinoma: an update on current practice

Maguire

Brogi

2015

Histopathology

View full text Add to dashboard Cite

Sentinel lymph node (SLN) biopsy has been established as the standard of care for axillary staging in patients with invasive breast carcinoma and clinically negative lymph nodes (cN0). Historically, all patients with a positive SLN underwent axillary lymph node dissection (ALND). The ACOSOG Z0011 trial showed that women with T1-T2 disease and cN0 who undergo breast conserving surgery and whole-breast radiotherapy can safely avoid ALND. The main goal of SLN examination should be to detect all macrometastases (>2mm). Gross sectioning SLNs at 2 mm intervals and microscopic examination of one H&E-stained section from each SLN block is the preferred method of pathologic evaluation of SLNs. The role and timing of SLN biopsy for patients having neoadjuvant chemotherapy is controversial and continues to be explored in clinical trials. SLN biopsies from patients with invasive breast carcinoma who have received neoadjuvant chemotherapy pose particular challenges for pathologists.

show abstract

Achieving Breast Cancer Surgery in a Single Setting With Intraoperative Frozen Section Analysis of the Sentinel Lymph Node

Cited by 16 publications

References 29 publications

Non-Inferiority of Survival in Early Breast Cancer Patients with False-Negative Sentinel Nodes After Completing Axillary Lymph Node Dissection

Non-Inferiority of Survival in Early Breast Cancer Patients with False-Negative Sentinel Nodes After Completing Axillary Lymph Node Dissection

The role of sentinel lymph nodes in breast cancer. The current state of the problem.

Sentinel lymph nodes for breast carcinoma: an update on current practice

Contact Info

Product

Resources

About