Accuracy of imprint cytology for intraoperative diagnosis of sentinel node metastases in breast cancer.
OBJECTIVE
The aim of this study was to determine the accuracy of imprint cytology for the intraoperative diagnosis of sentinel node metastases in patients with breast cancer.


BACKGROUND
Accurate intraoperative diagnosis of sentinel node metastases enables the selection of patients who need axillary lymph node dissection during the same operation.


METHODS
This study included 631 patients with clinical T1 breast cancer with clinically negative nodes. Sentinel nodes were serially sectioned at 2-mm intervals. Imprint cytologic samples were made from all cut surfaces and stained with Papanicolaou staining. Patients with positive sentinel nodes underwent immediate axillary lymph node dissection. Those with negative sentinel nodes diagnosed by intraoperative imprint cytology, but positive by final pathologic results, underwent subsequent axillary lymph node dissection. The results of imprint cytology were compared with the final pathologic results using hematoxylin and eosin staining and immunohistochemistry.


RESULTS
In 110 of 130 patients with positive sentinel nodes diagnosed by final pathology, imprint cytology of at least one sentinel node was positive. In 17 of 501 patients with tumor-negative sentinel nodes diagnosed by final pathology, imprint cytology of at least one sentinel node was positive. The sensitivity, specificity, and overall accuracy of imprint cytology for the diagnosis of sentinel node metastases were 84.6%, 96.6%, and 94.1%, respectively. Only 20 (3.2%) patients required a second axillary operation in the present study.


CONCLUSIONS
Intraoperative imprint cytology is a useful method for evaluating sentinel node metastasis in patients with breast cancer.
Motomura
Kazuyoshi
K
Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Higashinari-ku, Osaka, Japan. motomurak@hotmail.com
Nagumo
Sachiko
S
Komoike
Yoshifumi
Y
Koyama
Hiroki
H
Inaji
Hideo
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D016591:Histocytological Preparation Techniques; D006801:Humans; D007430:Intraoperative Care; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy