scholarly journals Is there a role of frozen section of sentinel lymph node in patients with early breast cancer for the management of axilla in India: a prospective study

2019 ◽  
Vol 6 (6) ◽  
pp. 2126
Author(s):  
Anshika Arora ◽  
Neena Chauhan ◽  
Sunil Saini ◽  
Nishish Vishwakarma ◽  
Tanvi Luthra
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Early Breast Cancer ◽  
False Positive ◽  
Frozen Section ◽  
False Negative ◽  
Lymph Node Biopsy ◽  
True Negative ◽  
Node Negative

Background: Evaluation of axilla using sentinel lymph node biopsy (SLNB) is the standard of care in node negative early breast cancer. Intra operative assessment of SLNB with frozen section (FS) often guides the surgeon regarding decision for level of axillary dissection. The aim of this study was to evaluate accuracy of FS of SLNB in these patients with histopathology examination (HPE) as the gold standard.Methods: This study was performed between July 2017 and November 2018. After gross evaluation of SLNB, nodes were cut in half and frozen; the other half was preserved for HPE. For FS, nodes were sectioned to 4 mm width and examined.Results: A total of 61 patients underwent SLNB, 55 patients undergoing intra-operative FS. The mean age was 53 years (range 30-84, ± 15.09 SD), primary tumor was clinically T1 in 23.6%, T2 in 76.4% patients. A median of four sentinel nodes were identified, mean size 13.84 mm. On FS SLNB was positive for metastasis in 14 (25.5%), on HPE in 16 (29.1%) patients. There were 13 true positive, 38 true negative, 3 false negative and 1 false positive result for FS. The sensitivity, specificity, positive and negative predictive value, false negative and false positive rates were 81.25%, 97.44%, 92.86%, 92.73%, 18.75% and 2.56% respectively in this study. The overall accuracy of FS of SLNB in early carcinoma breast was found to be 92.73%.Conclusions: An intra-operative FS of the SLN in node negative early breast cancer is a highly sensitive tool in axilla management.

scholarly journals Sentinel Lymph Node Biopsy in Early Breast Cancer Using the Indocyanine Green Fluorescence Technique: A Validation Study

2021 ◽  
Vol 20 (3) ◽  
Author(s):  
Loh Soon Khang ◽  
Suraya Baharudin ◽  
Juliana Abdul Latiff ◽  
Siti Aishah Mahamad Dom ◽  
Shahrun Niza Suhaimi
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Early Breast Cancer ◽  
Detection Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Lymph Node Biopsy ◽  
Blue Dye ◽  
Node Biopsy

INTRODUCTION: Introduction: Sentinel lymph node biopsy (SLNB) is now recognized as the standard of care for early breast cancer patients with negative axillary lymph nodes. Various approaches for Sentinel Lymph Node (SLN) identification using either the blue dye method or scintigraphy alone or their combination have been proposed. However, this method is costly and may not be applicable in certain developing countries. SLNB involving the use of indocyanine green (ICG) offers several advantages, and it is valid and safe when in direct comparison with the blue dye method and scintigraphy. Hence, we performed SLNB using this method in early breast cancer as the first center that involves the use of ICG in Malaysia. We performed validation study on this method with the aims to determine its sensitivity and safety profile. MATERIALS AND METHODS: This is a validation and non-randomised prospective observational study involving 20 patients underwent SLNB wherein ICG is used for localisation. The patients were recruited according to the recommendations stipulated in the Malaysia Clinical Practice Guideline. RESULT: The average number of SLNs removed per patient was 4.0 (range, 3–6) with sentinel lymph nodes detection rate at 98.75% (79/80). The false negative rate is at 5%. No adverse events were observed in all cases. CONCLUSION: The ICG fluorescence method is simple, reliable and safe. Moreover, it demonstrates a high SLN detection rate with a low false-negative rate, and it does not require a special instrument for radioisotope use.

False-negative frozen section of sentinel lymph node biopsy for breast cancer

The Breast ◽  
2004 ◽  
Vol 13 (1) ◽  
pp. 42-48 ◽  
Author(s):  
S Holck ◽  
H Galatius ◽  
U Engel ◽  
F Wagner ◽  
J Hoffmann
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Frozen Section ◽  
False Negative ◽  
Lymph Node Biopsy ◽  
Node Biopsy

Accuracy of sentinel lymph node biopsy in invasive lobular carcinoma of the breast.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e12604-e12604
Author(s):  
Ruby Guo ◽  
Case E. Brabham ◽  
Kelly Fahrner-Scott ◽  
Mary Kathryn Abel ◽  
Jasmine Wong ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lobular Carcinoma ◽  
False Negative ◽  
Lymph Node Biopsy ◽  
Sentinel Nodes ◽  
Node Negative ◽  
Node Biopsy

e12604 Background: The safety of the sentinel lymph node biopsy procedure (SLNB) in the surgical management of breast cancer relies upon a false negative rate (FNR) being less than 10%. The accuracy of SLNB in invasive lobular carcinoma (ILC), the second most common type of breast cancer, has not been evaluated. Because of high rates of false negative imaging and the diffuse growth pattern in ILC, less accurate pre-operative staging and a potentially unreliable lymphatic drainage pattern may impact the accuracy of SLNB in this tumor type. We therefore sought to characterize the accuracy of SLNB in a cohort of patients with ILC. Methods: We queried an institutional database of 707 patients with ILC and identified 196 patients who underwent SLN mapping with excision of both sentinel and non-sentinel nodes. A false negative was defined as having negative sentinel lymph nodes and a positive non-sentinel node. We calculated the FNR and sensitivity of SLNB and evaluated clinicopathologic variables. Results: Of 196 cases, 183 were clinically node-negative, 9 were clinically node-positive, and 4 had unknown clinical node status. Of the 183 clinically node-negative patients, 69 (37.7%) patients had node-positive disease at surgery. Overall, 7 of 196 cases had false negative SLNB, yielding an FNR of 8.97%. The sensitivity of SLNB was 91%. Patients with a false negative SLNB were significantly older than patients without (mean age 63 versus 54.7 years, p = 0.041). Significantly fewer sentinel and non-sentinel nodes were removed in women aged 50 years or older compared to those under 50 (1.9 vs. 2.5 sentinel nodes, p = 0.0158; 4.7 vs. 7.9 non-sentinel nodes, p = 0.0077). There were no differences in tumor receptor subtype, grade, stage, presence of lymphovascular invasion, or receipt of neoadjuvant therapy in those with a false negative SLNB compared to those without. Conclusions: The high rate of nodal positivity in clinically node negative patients highlights the challenges of clinical nodal assessment in ILC. Despite this, the SLNB procedure had a FNR that fell within the acceptable range, supporting its use in ILC. The relationship between number of sentinel nodes removed and FNR deserves further study, particularly in older women where extent of nodal surgery continues to decline.

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