Towards reasonable workload in diagnosis of sentinel lymph nodes: comparison of two frozen section methods.
OBJECTIVE
To compare two methods of histological assessment with intraoperative diagnosis of sentinel node metastases in breast cancer.


RESULTS
A total of 204 consecutive breast cancer cases with lymphatic mapping, sentinel node biopsy and intraoperative diagnosis were included. The sentinel nodes in the first 102 cases (method A) were bisected and serially sectioned. In the other 102 cases (method B) the nodes were sliced thinly with a razor blade. All 1-1.5 mm thick slices were mounted on prechilled mounting medium on frozen section buttons. Cytological imprints were also made of the attached tissue slices. Postoperative diagnosis of sentinel lymph node metatases was taken as gold standard. Sentinel node metastases were found in 28 (27%) cases in group A and in 42 (40%) cases in group B (P = 0.05). The median size of the sentinel node metastases was 4.3 mm in group A and 3.3 mm in group B (P < 0.05).


CONCLUSIONS
Method B finds more and smaller metastases and takes less time and effort in the laboratory. When using method A, many small metastases are not detected at all.
Krogerus
L A
LA
Department of Pathology, Maria Hospital, Helsinki University Hospital, Helsinki, Finland. leena.krogerus@hus.fi
Leidenius
M H K
MH
Toivonen
T S
TS
von Smitten
K J A
KJ
D000230:Adenocarcinoma / Q000737:chemistry / Q000175:diagnosis / Q000556:secondary / Q000601:surgery; D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000737:chemistry / Q000175:diagnosis / Q000601:surgery; D005629:Frozen Sections / Q000379:methods*; D006801:Humans; D007150:Immunohistochemistry; D007432:Intraoperative Period; D008198:Lymph Nodes / Q000737:chemistry / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000175:diagnosis; D010338:Pathology, Clinical / Q000379:methods*; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy; D016526:Workload
D014408:Biomarkers, Tumor