Low sensitivity of the touch imprint cytology of the sentinel lymph node in breast cancer patients—results of a large series

Abstract

TIC is a simple, quick, and sensitive method of intraoperative SLNs evaluation for the presence of the macrometastases. TIC has a very limited value in detecting micrometastases and no value in detecting ITC. TIC may not be indicated in T1a + b tumors.

Factors associated with the misdiagnosis of sentinel lymph nodes using touch imprint cytology for early stage breast cancer

“…The results from the present study are in accordance with previously published data indicating that the TIC technique provides acceptable accuracy in detecting macrometastasis, but not micrometastasis (2,6,10,11). The sensitivity of TIC in published studies varies widely from 34% (11) to 96% (9).…”

“…The sensitivity in our study was moderate (76.6%) by taking 2-to 3-mm serial slices of the sentinel node. Studies have found that this cutting interval may increase the sensitivity of TIC by increasing the effective surface area for analysis, allowing for the detection of small deposits and micrometastasis while increasing the pathological reporting time (2,(11)(12)(13)(14)(15)(16). In our institution, intraoperative assessment is accomplished during primary surgery and does not appear to prolong the surgical procedure.…”

Meta-analysis of sentinel node imprint cytology in breast cancer

“…A further possibility was contamination of the specimen from another sample when it was immersed in the fixing solution 11 .…”

“…There has been great interest recently in the use of imprint cytology to examine the sentinel node(s) in women with breast cancer, but there is variation in the reported sensitivity of the method. This heterogeneity has been attributed to several factors: variation in the experience of pathologists, the use of serial sectioning of the lymph node, the proportion of lymph node micrometastases in the series 11 and the proportion of metastases that originate from lobular carcinoma 12 .…”

Ljubljana nomograms for predicting the likelihood of non-sentinel lymph node metastases in breast cancer patients with a positive sentinel lymph node

“…The SLN metastasis size, which is known to be strongly associated with non-SLN metastases [23][24][25][26][27], was statistically significant only when the results of intraoperative examination of SLNs were not available (the first model in patients in whom intraoperative examination of SLNs was not performed and the second model). It is known that TIC is less likely positive, when tumor burden in SLNs is small and is thus a surrogate of SLN metastasis size [17,28]. In addition, patients with only clinically uninvolved axillary lymph nodes have larger tumor burden in SLNs than those with ultrasonically uninvolved axillary lymph nodes [14].…”