title: Diagnostic value of intraoperative histopathological examination of the sentinel nodes in breast cancer and skin melanoma-Preliminary results of single centre retrospective study.
abstract: OBJECTIVE
  Intraoperative histopatological examination of the sentinel nodes enables selection of patients who need dissection of the regional lymphatic system during the same operation. The aim of this study is to evaluate the diagnostic value of intraoperative histopathological examination of the sentinel nodes in breast cancer and skin melanoma. Intraoperative histopathology of the sentinel nodes as a diagnostic method is used in patients with melanoma and breast cancer. Recent studies have proved it to be an effective method for evaluating the nodes in the final histopathology. Intraoperative histopathological examination of the sentinel nodes is not performed routinely and there is no clear position on this issue. In this paper we try to prove that intraoperative test gives patients the simultaneous benefits of removal of regional lymph nodes metastases and earlier initiation of adjuvant therapy.
  
  
  METHODS
  The study comprises 137 patients with breast cancer and 35 patients with malignant skin melanoma. Sentinel nodes were intraoperatively sectioned and examined by means of the imprint method and frozen section evaluation. The patients with positive sentinel nodes underwent immediate dissection of regional lymph nodes. Those with negative sentinel nodes diagnosed in the intraoperative examination, but positive in final pathologic results, underwent subsequent dissection of regional lymph nodes.
  
  
  RESULTS
  60 sentinel lymph nodes were found in 35 patients with skin melanoma. In 3 patients, 3 sentinel lymph nodes were false negative in the intraoperative histopathological examination. No false positive sentinel lymph nodes were found. 249 sentinel lymph nodes were found in the intraoperative histopathological examination in 137 patients with breast cancer. There were no false positive sentinel nodes, but there were 7 false negative sentinel nodes. In this study, only 5 (3.6%) patients with breast cancer and 3 (8.5%) patients with skin melanoma required another regional operation.
  
  
  CONCLUSIONS
  The method of intraoperative histopathological evaluation of the sentinel nodes enables identification of metastases in these lymph nodes and gives a possibility to carry out a one-step regional lymphadenectomy and start the adjuvant therapy earlier.
authors.affiliation: 1st Clinic of Surgical Oncology and General Surgery, Greater Poland Cancer Centre, ul. Garbary 15, 61-866 Poznań, Poland.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Niziołek
authors.affiliation: 1st Clinic of Surgical Oncology and General Surgery, Greater Poland Cancer Centre, ul. Garbary 15, 61-866 Poznań, Poland.
authors.forename: Dawid
authors.initials: D
authors.lastname: Murawa
keywords: Breast cancer; Intraoperative histopatological examination of the sentinel nodes; Skin melanoma