Intraoperative consultation for axillary sentinel lymph node biopsy: an 8-year audit.
To summarize the authors' 8-year institutional experience with intraoperative consultation via frozen section (FS) on sentinel lymph node biopsy (SLNB) in breast cancer patients we recorded the, complete operative procedure including additional surgery on the ipsilateral axilla and intraoperative consultation and permanent histopathologic processing for all cases with inoperative consultation on SLNB in breast cancer patients between the groups, chi(2) and Fisher's exact tests were used. Intraoperative consultation was positive in 116/706 cases (16.4%) and final pathology in 158/706 cases (22.4%); the false-negative rate was 26.6%, the false-positive rate was 0%, and the overall accuracy was 94%. False-negative rate was significantly associated with the size of metastasis (micro vs macrometastasis; P < .002) but not significantly associated with the histologic type (P = 0.76) or pathologist expertise (P = 0.08). The rate of spared second procedures was 92% when calculated exclusively for patients who ultimately underwent ALND. Intraoperative consultation via FS for SLNB is a safe practice that can reliably save clinically node-negative patients a second surgery.
Nofech-Mozes
Sharon
S
Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Hanna
Wedad M
WM
Cil
Tulin
T
Quan
May-Lynn
ML
Holloway
Claire
C
Khalifa
Mahmoud A
MA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D005188:False Negative Reactions; D005260:Female; D005629:Frozen Sections; D006801:Humans; D007430:Intraoperative Care; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008485:Medical Audit; D008875:Middle Aged; D011237:Predictive Value of Tests; D012017:Referral and Consultation / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy; D055815:Young Adult