Is Necessary Intraoprative Frozen Section In Sentinel Lymph Node Biopsy For Breast Cancer Patients?

Abstract

Background: Improvements in the process of staging and surgical treatment of axillary lymph nodes in recent years, have led to the use of intra operative frozen section pathology to examine the sentinel lymph node biopsy in breast cancer patients. Materials and Methods: we evaluated the results of the Sentinel biopsy in 102 patients with early stage breast cancer, which were negative clinical lymph nodes, and analyzing the true positive and false negative rate, diagnostic accuracy of frozen section lymph node biopsy. It also studied the factors affecting the sentinel and non-sentinel lymph nodes in patients treated by axillary lymph dissection. Results: In this study, we investigated 102 patients' stage 1and 2 breast cancer with clinical negative axillary lymph node and candidates for sentinel lymph node biopsy, were placed under investigation. 15.7 % of the real positive results of sentinel and 62.7 % of the real negative and 2 % false positives and 20.9 % false negative results and% 78. 4 diagnostic accuracy, has been frozen section. Among the patients who were initially or delayed in the axillary dissection, 37% had more than two lymph nodes. While in general, 16.7% of patients had a need for axillary lymph node dissection based on z11 criteria. Lymph-vascular invasion was a major contributor to lentil involvement in Sentinel and non-Sentinel nodes. Conclusion: Frozen section pathology during the operation of sentinel lymph node biopsy has been initiated to prevent the need for a reoperation in early stage breast cancer patients. However, due to low tumor burden in patients who are candidates for this procedure, and the constraints in the initial sections and their false negative results, also the removal of frozen section will not have an effect on the rate of increasing reoperation and can be effective in reducing the time and cost of surgery.

A Radiomics Model for Preoperative Predicting Sentinel Lymph Node Metastasis in Breast Cancer Based on Dynamic Contrast-Enhanced MRI

“…To reduce the complications of ALND, including arm edema, sensory disturbances, impairment of arm mobility, and shoulder stiffness ( 13 ), SLNB is currently the standard procedure for patients with clinically node-negative BC ( 14 ). Memorial Sloan Kettering Cancer Center (MSKCC) nomogram based on clinical parameters has been the most widely used model to evaluate the SLN state ( 15 , 16 ).…”

Avoiding unnecessary intraoperative sentinel lymph node frozen section biopsy of patients with early breast cancer

“…In studies that actively omitted ALND (guided by the ACOSOG Z0011 trial data), the need for SLN frozen section biopsy was minimal [ 11 13 ]. However, studies that questioned the appropriateness of ALND omission argued the need for frozen section biopsy [ 8 9 11 14 15 ].…”

Narrative review of sentinel lymph node biopsy in breast cancer: a technique in constant evolution with still numerous unresolved questions

“…Moreover, the false negative rates of frozen section are high (25-30%), and it has been proven that the intraoperative LN examination had only a small impact on the rate of reoperation and increased the time and cost of surgery (46). Frozen section is a less efficient histological technique which can lead to a risk of loss of material.…”