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- Title
CORRELATION OF INTRAOPERATIVE CONSULTATION DIAGNOSIS AND PERMANENT DIAGNOSIS IN SENTINEL LYMPH NODES IN RESECTED BREAST SPECIMENS AT DANBURY HOSPITAL A 3-YEAR RETROSPECTIVE STUDY.
- Authors
Birusingh, Rhea J.; Escudero, German; Vidhun, Ramapriya; El-Fanek, Hani
- Abstract
The single most important predictor of prognosis in women with breast cancer is the status of lymph node involvement by metastatic carcinoma. The sentinel lymph node is the first lymph node within the axillary lymphatic chain draining the primary tumor and as such, would be the most likely lymph node to harbor metastatic neoplastic cells. The use of intraoperative consultations for detecting involvement in the sentinel lymph node has become a common practice as it allows for staging of the patient while on the operating table. As a result, it reduces the need for a second procedure to remove the axillary lymph nodes if the sentinel lymph node is involved. However, the sensitivity of intra-operative consultations using imprint cytology has been questioned. our study is a retrospective review of the intraoperative diagnosis and the permanent diagnosis of sentinel lymph nodes that were sent to our Surgical Pathology laboratory over a three-year period, 2005-2007. A total of 303 cases with sentinel lymph nodes were reviewed for the three year time period. Of the 303 cases, 75 cases had positive sentinel lymph nodes on permanent sections. Of the 75 positive cases, 31 cases were diagnosed as positive intraoperatively and 43 cases were called negative intraoperatively using imprint cytology. One case was called suspicious for malignant cells using imprint cytology and a frozen section of the lymph node was negative; the permanent sections were positive for malignant cells. The sensitivity of imprint cytology for the evaluation of sentinel lymph nodes in our laboratory was 41%. In 1999, the College of American Pathologists recommended the use of cytology for the evaluation of intraoperative consultations for sentinel lymph nodes. The literature has reported sensitivity ranges for imprint cytology of 29% to 94% with approximately 40% of patients with positive lymph node metastasis being detected intraoperatively using imprint cytology. There are a number of different methods for intraoperative evaluation of sentinel lymph nodes including frozen sections of tissue and intraoperative cytokeratin immunohistochemistry. However, these methods have their own shortcomings and as of this time, do not have a better sensitivity than imprint cytology. our study compares favorably with the published studies.
- Subjects
DANBURY (Conn.); CONNECTICUT; INTRAOPERATIVE monitoring; LYMPH nodes; BREAST cancer patients; BREAST cancer surgery; CYTOLOGY; HOSPITALS
- Publication
Connecticut Medicine, 2009, Vol 73, Issue 1, p21
- ISSN
0010-6178
- Publication type
Article