Imprint cytology versus frozen section analysis for intraoperative assessment of sentinel lymph node in breast cancer

Thalia Petropoulou,1 Antonia Kapoula,2 Aikaterini Mastoraki,3 Aikaterini Politi,2 Eleni Spanidou-Karvouni,2 Ioannis Psychogios,1 Ioannis Vassiliou,1 Nikolaos Arkadopoulos3 12nd Department of Surgery, 2Department of Pathology, Aretaieion University Hospital, 34th Department of Surgery, Athens Univers...

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Autores principales:	Petropoulou T, Kapoula A, Mastoraki A, Politi A, Spanidou-Karvouni E, Psychogios I, Vassiliou I, Arkadopoulos N
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Breast Cancer Sentinel Lymph Node Biopsy Frozen Section Imprint Cytology. Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/4bda39db91d246e2bad7a099ae2892e4
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spelling	oai:doaj.org-article:4bda39db91d246e2bad7a099ae2892e42021-12-02T05:14:05ZImprint cytology versus frozen section analysis for intraoperative assessment of sentinel lymph node in breast cancer1179-1314https://doaj.org/article/4bda39db91d246e2bad7a099ae2892e42017-05-01T00:00:00Zhttps://www.dovepress.com/imprint-cytology-versus-frozen-section-analysis-for-intraoperative-ass-peer-reviewed-article-BCTThttps://doaj.org/toc/1179-1314Thalia Petropoulou,1 Antonia Kapoula,2 Aikaterini Mastoraki,3 Aikaterini Politi,2 Eleni Spanidou-Karvouni,2 Ioannis Psychogios,1 Ioannis Vassiliou,1 Nikolaos Arkadopoulos3 12nd Department of Surgery, 2Department of Pathology, Aretaieion University Hospital, 34th Department of Surgery, Athens University Medical School, Attikon University Hospital, Chaidari, Athens, Greece Introduction: Sentinel lymph node (SLN) biopsy is the gold standard for surgical staging of the axilla in breast cancer (BC). Frozen section (FS) remains the most popular means of intraoperative SLN diagnosis. Imprint cytology (IC) has also been suggested as a less expensive and equally accurate alternative to FS. The aim of our study was to perform a direct comparison between IC and FS on the same SLNs of BC cases operated in a single center by the same surgical team.Materials and methods: Into this prospective study we enrolled 60 consecutive patients with histologically proven T1–T3 BC and clinically negative axilla. Sentinel nodes were detected using a standard protocol. The SLN(s) was always assessed by IC as well as FS analysis and immunohistochemistry. Nevertheless, all intraoperative decisions were based on FS analysis.Results: During the study period 60 patients with invasive BC were registered, with 80 SLNs harvested. Mean number of SLN(s) identified for each patient was 1.33. The sensitivity and specificity were 90% and 100%, respectively, for IC, and 80% and 100% for FS. Relevant positive/negative predictive values were 100%/98% for IC and 100%/96.15%, respectively, for FS. Overall accuracy was 98% for IC and 97% for FS. Therefore, statistically significant difference between the two methods in the detection of positive nodes was not elucidated (p=1.000).Conclusions: IC appeared to be marginally more sensitive than FS in detecting SLN metastatic activity. Overall accuracy was 98.75%. With regard to the primary lesion characteristics, we conclude that initial lesion size and lymphovascular invasion play a pivotal role in metastatic involvement of the SLN with the dimensions of metastasis bearing no correlation with tumor size. Therefore, IC appears to be a sensitive and accurate method for the intraoperative assessment of SLN in BC patients, but further studies are required to confirm this interesting data. Keywords: breast cancer, sentinel lymph node biopsy, frozen section, imprint cytologyPetropoulou TKapoula AMastoraki APoliti ASpanidou-Karvouni EPsychogios IVassiliou IArkadopoulos NDove Medical PressarticleBreast CancerSentinel Lymph Node BiopsyFrozen SectionImprint Cytology.Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBreast Cancer: Targets and Therapy, Vol Volume 9, Pp 325-330 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Breast Cancer Sentinel Lymph Node Biopsy Frozen Section Imprint Cytology. Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Breast Cancer Sentinel Lymph Node Biopsy Frozen Section Imprint Cytology. Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Petropoulou T Kapoula A Mastoraki A Politi A Spanidou-Karvouni E Psychogios I Vassiliou I Arkadopoulos N Imprint cytology versus frozen section analysis for intraoperative assessment of sentinel lymph node in breast cancer
description	Thalia Petropoulou,1 Antonia Kapoula,2 Aikaterini Mastoraki,3 Aikaterini Politi,2 Eleni Spanidou-Karvouni,2 Ioannis Psychogios,1 Ioannis Vassiliou,1 Nikolaos Arkadopoulos3 12nd Department of Surgery, 2Department of Pathology, Aretaieion University Hospital, 34th Department of Surgery, Athens University Medical School, Attikon University Hospital, Chaidari, Athens, Greece Introduction: Sentinel lymph node (SLN) biopsy is the gold standard for surgical staging of the axilla in breast cancer (BC). Frozen section (FS) remains the most popular means of intraoperative SLN diagnosis. Imprint cytology (IC) has also been suggested as a less expensive and equally accurate alternative to FS. The aim of our study was to perform a direct comparison between IC and FS on the same SLNs of BC cases operated in a single center by the same surgical team.Materials and methods: Into this prospective study we enrolled 60 consecutive patients with histologically proven T1–T3 BC and clinically negative axilla. Sentinel nodes were detected using a standard protocol. The SLN(s) was always assessed by IC as well as FS analysis and immunohistochemistry. Nevertheless, all intraoperative decisions were based on FS analysis.Results: During the study period 60 patients with invasive BC were registered, with 80 SLNs harvested. Mean number of SLN(s) identified for each patient was 1.33. The sensitivity and specificity were 90% and 100%, respectively, for IC, and 80% and 100% for FS. Relevant positive/negative predictive values were 100%/98% for IC and 100%/96.15%, respectively, for FS. Overall accuracy was 98% for IC and 97% for FS. Therefore, statistically significant difference between the two methods in the detection of positive nodes was not elucidated (p=1.000).Conclusions: IC appeared to be marginally more sensitive than FS in detecting SLN metastatic activity. Overall accuracy was 98.75%. With regard to the primary lesion characteristics, we conclude that initial lesion size and lymphovascular invasion play a pivotal role in metastatic involvement of the SLN with the dimensions of metastasis bearing no correlation with tumor size. Therefore, IC appears to be a sensitive and accurate method for the intraoperative assessment of SLN in BC patients, but further studies are required to confirm this interesting data. Keywords: breast cancer, sentinel lymph node biopsy, frozen section, imprint cytology
format	article
author	Petropoulou T Kapoula A Mastoraki A Politi A Spanidou-Karvouni E Psychogios I Vassiliou I Arkadopoulos N
author_facet	Petropoulou T Kapoula A Mastoraki A Politi A Spanidou-Karvouni E Psychogios I Vassiliou I Arkadopoulos N
author_sort	Petropoulou T
title	Imprint cytology versus frozen section analysis for intraoperative assessment of sentinel lymph node in breast cancer
title_short	Imprint cytology versus frozen section analysis for intraoperative assessment of sentinel lymph node in breast cancer
title_full	Imprint cytology versus frozen section analysis for intraoperative assessment of sentinel lymph node in breast cancer
title_fullStr	Imprint cytology versus frozen section analysis for intraoperative assessment of sentinel lymph node in breast cancer
title_full_unstemmed	Imprint cytology versus frozen section analysis for intraoperative assessment of sentinel lymph node in breast cancer
title_sort	imprint cytology versus frozen section analysis for intraoperative assessment of sentinel lymph node in breast cancer
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/4bda39db91d246e2bad7a099ae2892e4
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Imprint cytology versus frozen section analysis for intraoperative assessment of sentinel lymph node in breast cancer

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