title: Eight-year experience with the intraoperative frozen section examination of sentinel lymph node biopsy for breast cancer in a North-Italian university center.
abstract: Sentinel lymph node biopsy (SLNB) completely changed the impact of breast surgery on patients psycho-physical wellness, reducing morbidity associated with complete axillary lymph node dissection (CALND) while granting an adequate breast cancer staging. We reviewed our experience with the SLNB in a University Clinic. We collected data about all breast cancer patients submitted to SLNB from 2002 to 2010, and analyzed them with R (version 2.15.2), considering significant p<0.05. We performed 615 SLNBs on 607 patients, with a mean age of 59.86 (±10.76). Sentinel node detection rate resulted 99,7%, with a mean number of biopsied nodes of 1.64 (±0.67), axillary localization in 98% of cases, and negative intraoperative histological finding in the 86.2% of cases. Prevalence of ITCs, micrometastasis, macrometastasis and pericapsular metastasis resulted respectively 0.6%, 4.9%, 7.5% and 8.8%. Among women who received CALND, mean number of examined nodes was 16.36 (±6.19) and mean number of metastatic non-sentinel nodes was 0.97 in case of micrometastasis, 2.65 in case of macrometastasis, and up to 9.88 when pericapsular invasion was described. To conclude, our data confirm the role of nodal metastasis size in the prediction of non-sentinel node involvement, but further studies are required in order to better assess the role of ITCs and micrometastasis in the diagnostic and therapeutic management of breast cancer, with the final aim to reduce the surgical complications of axilla demolition when unnecessary.
authors.affiliation: Clinic of Surgery, University of Udine Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Cedolini
authors.affiliation: Clinic of Surgery, University of Udine Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Bertozzi
authors.affiliation: Clinic of Surgery, University of Udine Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Seriau
authors.affiliation: Clinic of Obstetrics and Gynecology, University of Udine Italy.
authors.forename: Ambrogio P
authors.initials: AP
authors.lastname: Londero
authors.affiliation: Clinic of Surgery, University of Udine Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Concina
authors.affiliation: Clinic of Surgery, University of Udine Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Cattin
authors.affiliation: Department of Nuclear Medicine, Az. Osp.-Univ. "Santa Maria della Misericordia" Udine, Italy.
authors.forename: Onelio
authors.initials: O
authors.lastname: Geatti
authors.affiliation: Institute of Pathology, University of Udine Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Di Loreto
authors.affiliation: Clinic of Surgery, University of Udine Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Risaliti
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology*; D002277:Carcinoma / Q000473:pathology*; D005260:Female; D005629:Frozen Sections / Q000379:methods*; D006801:Humans; D007558:Italy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008875:Middle Aged; D021701:Sentinel Lymph Node Biopsy
keywords: Breast cancer; breast invasive cancer; micrometastasis; sentinel lymph node; sentinel lymph node biopsy