Intra-operative examination of the sentinel node in breast cancer

Ir Med J. 2008 Apr;101(4):120-2.

Abstract

Intra-operative sentinel node analysis allows immediate progression to axillary clearance in patients with node positive breast cancer and reduces the need for re-operation. Despite this, intra-operative sentinel node analysis is infrequently performed in Ireland. We report our experience using this technique. Sentinel node biopsy was performed in 47 consecutive patients with symptomatic T1-T2 clinically node negative breast cancer. Sentinel nodes were examined intra-operatively by frozen section and imprint cytology and definitive histological assessment was performed on paraffin-embedded tissue. The sentinel node was identified in 46 (98%) patients. Twelve patients had axillary metastases. The sensitivity of intra-operative analysis in identifying nodal metastases was 92%. False negative rate was 8%, negative predictive value 97%, and specificity 100%. Intra-operative analysis of the sentinel node allowed re-operation to be avoided in 92% of patients with axillary node metastases. In our experience this technique can be readily introduced with reliable outcomes.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery
  • Disease Progression
  • Female
  • Humans
  • Intraoperative Period*
  • Ireland
  • Middle Aged
  • Radionuclide Imaging
  • Retrospective Studies
  • Sensitivity and Specificity
  • Sentinel Lymph Node Biopsy*
  • Technetium Tc 99m Aggregated Albumin

Substances

  • Technetium Tc 99m Aggregated Albumin