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- Title
Intraoperative analysis on sentinel lymph nodes of neoadjuvant breast cancer patients.
- Authors
Wong, Willard; Fang-I Lu
- Abstract
Objective: Intraoperative sentinel lymph node (SLN) evaluation is used to determine need for axillary lymph node dissection (ALND) in patients with breast cancer. Although accuracy of SLN frozen section (FS) diagnosis has been extensively studied, few studies have been done in the neoadjuvant setting. Our objective is to analyze the accuracy of post-neoadjuvant chemotherapy SLN FS diagnosis and perform subgroup analysis to identify features that may predict accuracy. Methods: We performed a retrospective chart review of neoadjuvant breast cancer patients with approval of the Research Ethics Board. A total of 161 SLN were analyzed from 49 patients. The intraoperative results were compared with final diagnoses and pertinent clinical data. Results: On a per case basis, sensitivity, specificity, and accuracy of FS analysis were 50, 100, and 84%, respectively. Eight of the 49 patients were found to have discordant FS and permanent section results (Table 1); two of eight patients went on to have ALND after permanent sections. On a per lymph node basis, sensitivity, specificity, and accuracy of FS analysis were 63, 100, and 94%, respectively. Conclusion: SLN FS diagnosis is specific and accurate postneoadjuvant chemotherapy. However, it has low sensitivity. In subgroup analysis, we find a greater proportion of false negatives in micrometastases and isolated tumour cells, as well as patients with radiologically larger primary tumour size. In addition, we find that all our false negatives are positive for estrogen receptor and 87.5% are negative for HER2/neu.
- Publication
Canadian Journal of Pathology, 2016, Vol 8, p39
- ISSN
1918-915X
- Publication type
Article