Intraoperative scrape cytology of the sentinel lymph node in patients with breast cancer.
BACKGROUND
Intraoperative examination of the sentinel lymph node (SLN) may detect metastatic disease, allowing immediate axillary lymph node dissection and therefore avoiding the need for reoperation. The aim of this study was to evaluate the accuracy of scrape cytology of the SLN in patients with early breast cancer.


METHODS
Sentinel node biopsy was performed in 148 patients with clinical T1-2 N0 breast cancer. After harvesting, the SLN was bisected and cells from both halves were scraped with a scalpel blade on to a slide and stained with a Papanicolaou and Giemsa stain. Scrape cytology results were compared with the results of paraffin sections stained with haematoxylin and eosin and with immunohistochemistry.


RESULTS
The intraoperative diagnosis was correct in 126 patients (85 per cent). Sensitivity and specificity were 67 and 98 per cent respectively; positive and negative predictive values were 95 and 81 per cent.


CONCLUSIONS
Scrape cytology is a useful method for intraoperative evaluation of the SLN in patients with breast cancer.
Smidt
M L
ML
Department of General Surgery, Canisius Wilhelmina Hospital, Postbus 9015, 6500 GS Nijmegen, The Netherlands. marjoleinsmidt@yahoo.com
Besseling
R
R
Wauters
C A P
CA
Strobbe
L J A
LJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D007430:Intraoperative Care / Q000379:methods; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*