INTRODUCTION: Intra-operative imprint cytology (IIC) for analysing sentinel lymph node/s (SLN) in breast cancer allows definitive axillary surgery as a one-step procedure. Most reported studies are research oriented. This study reports long-term results of IIC done as routine clinical practice. MATERIALS AND METHODS: Eight hundred ninety-six female, operable breast cancer patients underwent SLN biopsy over an 8-year period (January 1999-December 2006). Data were extracted retrospectively from medical records. SLNs were sent intra-operatively to the laboratory where they were bisected, touch imprinted and stained with Hematoxylin & Eosin. Patients with positive IIC had axillary clearance. Formal histological analyses of SLNs were compared with IIC findings. The impact of routine pre-operative axillary ultrasound (introduced in 2003) on IIC sensitivity and specificity was also assessed. RESULTS: Median age was 61 years (26-89) and median tumour size was 18 mm (2-100). A total of 244/896 patients had SLN metastases on final paraffin histology of which 177 were correctly detected by IIC (67 false negatives). 39/67 false negatives could be attributed to sampling error. The overall sensitivity and specificity of IIC for the identification of SLN metastases was 73% and 100%, respectively. The sensitivity of IIC after introduction of pre-operative axillary ultrasound decreased from 75% to 71%. DISCUSSION: Routine use of IIC for analysis of the SLN in breast cancer allows complete axillary surgery during a single anaesthetic for a majority of patients undergoing SLN biopsy. Almost two thirds of positive axillae were spared a second operation. False negative results are frequent and patients should be warned about the potential need for further axillary surgery.
INTRODUCTION: Intra-operative imprint cytology (IIC) for analysing sentinel lymph node/s (SLN) in breast cancer allows definitive axillary surgery as a one-step procedure. Most reported studies are research oriented. This study reports long-term results of IIC done as routine clinical practice. MATERIALS AND METHODS: Eight hundred ninety-six female, operable breast cancerpatients underwent SLN biopsy over an 8-year period (January 1999-December 2006). Data were extracted retrospectively from medical records. SLNs were sent intra-operatively to the laboratory where they were bisected, touch imprinted and stained with Hematoxylin & Eosin. Patients with positive IIC had axillary clearance. Formal histological analyses of SLNs were compared with IIC findings. The impact of routine pre-operative axillary ultrasound (introduced in 2003) on IIC sensitivity and specificity was also assessed. RESULTS: Median age was 61 years (26-89) and median tumour size was 18 mm (2-100). A total of 244/896 patients had SLN metastases on final paraffin histology of which 177 were correctly detected by IIC (67 false negatives). 39/67 false negatives could be attributed to sampling error. The overall sensitivity and specificity of IIC for the identification of SLN metastases was 73% and 100%, respectively. The sensitivity of IIC after introduction of pre-operative axillary ultrasound decreased from 75% to 71%. DISCUSSION: Routine use of IIC for analysis of the SLN in breast cancer allows complete axillary surgery during a single anaesthetic for a majority of patients undergoing SLN biopsy. Almost two thirds of positive axillae were spared a second operation. False negative results are frequent and patients should be warned about the potential need for further axillary surgery.
Authors: V M Pérez-Sánchez; T A Vela-Chávez; P Villarreal-Colin; E Bargalló-Rocha; M T Ramírez-Ugalde; D Munoz-Gonzalez; I Zeichner-Gancz Journal: Med Oncol Date: 2009-03-19 Impact factor: 3.064
Authors: Thalia Petropoulou; Antonia Kapoula; Aikaterini Mastoraki; Aikaterini Politi; Eleni Spanidou-Karvouni; Ioannis Psychogios; Ioannis Vassiliou; Nikolaos Arkadopoulos Journal: Breast Cancer (Dove Med Press) Date: 2017-05-05