title: Multiple Step-section Frozen Section sentinel lymph node biopsy--a review of 717 patients.
abstract: Sentinel Lymph Node Biopsy (SLNB) is the standard of care for axillary staging in breast cancer. Multiple Step-section Frozen Section (MSFS) analysis is used in our institution for SLNB. This is performed intra-operatively by freezing sentinel lymph nodes to obtain multiple step-sections which are examined histologically for evidence of metastases. Patients whose sentinel lymph nodes contained macrometastases proceeded to an axillary node clearance during the same operation. 717 patients over a two and a half year period had MSFS analysis. With regards to macrometastases, MSFS analysis had a sensitivity of 93.8%, a specificity of 99.3%, a positive-predictive value of 97.4% and a negative-predictive value of 98.2%. MSFS analysis of sentinel lymph nodes is a safe and accurate procedure. It is a relatively cost-effective alternative to molecular technologies relying on DNA amplification and more accurate than standard frozen section or touch-prep cytology.
authors: The Breast Care Centre, Southmead Hospital, North Bristol NHS Trust, Southmead Road, Westbury-on-Trym, Bristol BS10 5NB, UK. Electronic address: jeffrey.lim@doctors.net.uk.
authors: Jeffrey
authors: J
authors: Lim
authors: Sasirekha
authors: S
authors: Govindarajulu
authors: Ajay
authors: A
authors: Sahu
authors: Nassif
authors: N
authors: Ibrahim
authors: Sulaman
authors: S
authors: Magdub
authors: Simon
authors: S
authors: Cawthorn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000556:secondary*; D005260:Female; D005629:Frozen Sections / Q000379:methods*; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D061206:Neoplasm Micrometastasis / Q000473:pathology*; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D055815:Young Adult
keywords: ALND; Breast cancer; DCIS; Frozen section; MSFS; Multiple Step-section Frozen Section; OSNA; One Step Nucleic Acid Amplification; RT-PCR; Reverse Transcriptase Polymerase Chain Reaction; SLN; Sentinel node biopsy; WLE; axillary lymph node dissection; ductal carcinoma in-situ; sentinel lymph node; wide local excision