Sentinel lymph node biopsy assessment using intraoperative imprint cytology in breast cancer patients: results of a validation study.
OBJECTIVE
Sentinel lymph node biopsy (SLNB) in breast cancer patients is emerging as a promising minimally-invasive tool. There has been an exponential increase in the literature related to sentinel lymph nodes (SLN) in breast cancer patients, mainly from Western centres. This study was carried out to address issues relevant to breast cancer patients in developing countries, including the method of SLN detection, the role of imprint cytology in the assessment of SLN, and the role of SLNB in locally advanced breast cancer (LABC).


METHODS
This study included 76 women with breast cancer. The blue-dye method was used to identify the sentinel node. Touch imprint smears were prepared from the sectioned node, stained using the Jenner-Geimsa technique, and examined for tumour deposits.


RESULTS
Sentinel nodes were identified in 69 of 76 patients. The sensitivity, specificity and accuracy of SLNB in predicting axillary node status were 84.2%, 100% and 91.3%, respectively. The sensitivity, specificity and accuracy of intraoperative imprint cytology were 96.9%, 100% and 98.6%, respectively.


CONCLUSIONS
These results prove that high levels of SLN detection can be achieved using the blue-dye method alone. Its role in LABC patients needs further evaluation. In view of promising results, imprint cytology should be used more frequently as an alternative to frozen section for the assessment of sentinel nodes.
Deo
Suryanarayana
S
Department of Surgical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India. svsdeo@yahoo.co.in
Samaiya
Atul
A
Jain
Paresh
P
Asthana
Sonal
S
Anand
Mona
M
Shukla
Nootan K
NK
Kumar
Rajive
R
D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D004396:Coloring Agents; D003581:Cytodiagnosis / Q000379:methods; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008197:Lymph Node Excision; D008875:Middle Aged; D011446:Prospective Studies; D012394:Rosaniline Dyes; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods
D004396:Coloring Agents; D012394:Rosaniline Dyes; C025484:iso-sulfan blue