title: The use of frozen section and immunohistochemistry for sentinel lymph node biopsy in breast cancer.
abstract: Intraoperative pathologic evaluation of the sentinel lymph node (SLN) may guide immediate (synchronous) completion axillary lymph node dissection (ALND) for up to two-thirds of patients with nodal disease for breast cancer. The false-negative rates average one-third of cases, and one must be aware of false-positive results as this would result in unnecessary and morbid completion ALND. Currently, the use of immunohistochemistry (IHC) is controversial. There is no question that cytokeratin staining improves the sensitivity; however, there is no evidence that any of these "positive" cells are clinically significant and warrant therapy. Prospective randomized trials will be necessary to confirm or debunk the hypothesis that "sub-micrometastatic" disease has clinical significance.
authors.affiliation: Department of Surgery, The University of Texas Medical Branch, Galveston, Texas 77555-0527, USA.
authors.forename: Celia
authors.initials: C
authors.lastname: Chao
mesh_terms: D000465:Algorithms; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D003663:Decision Trees; D005188:False Negative Reactions; D005189:False Positive Reactions; D005629:Frozen Sections / Q000379:methods* / Q000592:standards; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods* / Q000592:standards; D007430:Intraoperative Care / Q000379:methods* / Q000592:standards; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology*; D009367:Neoplasm Staging / Q000379:methods / Q000592:standards; D018579:Patient Selection; D011379:Prognosis; D015203:Reproducibility of Results; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods* / Q000592:standards