title: [Diagnostic validity of the intraoperative analysis in frozen section of the sentinel lymph node in the surgical management of breast cancer].
abstract: OBJECTIVE
  The method for intraoperative sentinel lymph node (SLN) evaluation has still not been established in breast cancer staging. This study has evaluated the diagnostic validity and impact of intraoperative analysis using the frozen section (FS) of SLN.
  
  
  METHODS
  We performed a descriptive study of the diagnostic validity of the FS of the SLN in patients with breast cancer and selective sentinel node biopsy (SSNB) from October-2006 to October-2012. The diagnostic validity indexes were evaluated using sensitivity, specificity, positive and negative predictive values and global value. Gold standard was considered as the final histopathological results of the biopsies.
  
  
  RESULTS
  A total of 370 patients were studied. Sensitivity and specificity for detection of metastasis by FS in the SLN were 67% and 100%, respectively. Global diagnostic validity was 95%. There was a correlation between detection of metastasis and tumor size (p<0.05). Twelve of the 15 patients with SLN micro-metastases underwent axillary lymph node dissection (ALND). Metastatic lymph nodes were not found in any of them.
  
  
  CONCLUSIONS
  Intraoperative FS examination of the SLN is a useful and reliable predictor of axillary lymph node staging in patients with initial stages of breast cancer. FS reduces the need for second interventions, at least for most patients who have breast cancer with identifiable positive SLN and unequivocal evidence of positive lymph node disease.
authors.affiliation: Unidad de Medicina Nuclear, Hospital Universitario Fundación Alcorcón, Madrid, España. Electronic address: luisbanuelosh@msn.com.
authors.forename: Luis
authors.initials: L
authors.lastname: Bañuelos-Andrío
authors.affiliation: Servicio de Medicina Preventiva, Hospital Universitario Fundación Alcorcón, Madrid, España.
authors.forename: Gil
authors.initials: G
authors.lastname: Rodríguez-Caravaca
authors.affiliation: Servicio de Anatomía Patológica, Hospital Universitario Fundación Alcorcón, Madrid, España.
authors.forename: Miguel
authors.initials: M
authors.lastname: Argüelles-Pintos
authors.affiliation: Servicio de Medicina Nuclear, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Mitjavilla-Casanovas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005629:Frozen Sections; D006801:Humans; D007432:Intraoperative Period; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy
keywords: Breast cancer; Cáncer de mama; Frozen section; Ganglio centinela; Intraoperative; Intraoperatorio; Sección en congelación; Sentinel lymph node