Frozen section in axillary sentinel lymph nodes for diagnosis of breast cancer micrometastasis.
BACKGROUND
Sentinel lymph node (SLN) biopsy plays a major role in the surgical management of primary breast cancer. The aim of this study was to assess the diagnostic accuracy of the assessment of axillary frozen sections of SLNs for micrometastasis diagnosis.


METHODS
This study focused on 278 SLNs from 149 patients. Each lymph node was fully analyzed by frozen section. After fixation, serial sections were cut and stained by hematoxylin and eosin (HE) and for pan-cytokeratins by immunohistochemistry (IHC).


RESULTS
Tumor cells were detected in 63 SLNs, 41 on frozen sections and 22 on controls. Of these 63 positive SLNs, 42 contained metastases, 10 contained micrometastases and 11 contained isolated tumor cells. The specificity and positive predictive value of SLN frozen sections for micrometastasis was 100%. The sensitivity was 83.3% for metastasis, 40% for micrometastasis; the false-negative rate was 16.7% for metastasis and 60% for micrometastasis.


CONCLUSIONS
Analysis of frozen section of SLNs is an accurate method for metastasis detection, allowing concurrent axillary dissection when positive. The protocol for SLN analyses described herein shows good sensitivity for micrometastasis detection.
Tille
Jean-Christophe
JC
Department of Genetics and Laboratory Medicine, Geneva University Hospitals, 1211 Geneva 14, Switzerland. jean-christophe.tille@hcuge.ch
Egger
Jean-François
JF
Devillaz
Maria Condrea
MC
Vlastos
Goerges
G
Pelte
Marie-Françoise
MF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D005260:Female; D005629:Frozen Sections; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy; D055815:Young Adult