title: Should We Perform the Intraoperative Sentinel Lymph Node Biopsy in Breast Cancer?
abstract: The purpose of this study was to evaluate the utility of performing a selective intraoperative sentinel lymph node biopsy (SLNB) in breast cancer patients.
  
  
  
  Patients in this prospective study were women with breast cancer seen at our hospital in 2014. These patients were divided into 2 groups on the basis of the clinical criteria age, tumor size, and molecular subtype: (1) Group A: women with clinical criteria indicative of the need to perform an intraoperative analysis of the sentinel lymph node (SLN); and (2) Group B: women in whom postoperative analysis of the SLN was performed. The final anatomopathologic findings obtained for the SLNs were analyzed and the sensitivity, specificity, positive predictive value, and negative predictive value of the clinical criteria used to decide between intraoperative or postoperative analysis of the SLN were estimated.
  
  
  
  A total of 170 patients were included: 106 in group A and 64 in group B. The number of positive SLNs was 29 (22 in group A and 7 in group B; P = .09). The sensitivity of our clinical criteria for establishing the indication to perform an axillary SLNB was 75.86% (95% confidence interval [CI], 56.05%-88.98%), the specificity was 40.43% (95% CI, 32.35%-49.03%), the positive predictive value was 20.75% (95% CI, 13.73%-29.95%), and the negative predictive value was 89.06% (95% CI, 78.16%-95.12%).
  
  
  
  The clinical findings used to decide whether or not to perform an SLNB exhibit low sensitivity and specificity and must therefore not be used to decide the need for an intraoperative SLNB.
authors.affiliation: Gynecologic Oncology Unit, Obstetrics and Gynecology Clinical Management Unit, Araba University Hospital Osakidetza, Basque Public Health Service, Vitoria, Spain.
authors.forename: Nagore
authors.initials: N
authors.lastname: Ceberio
authors.affiliation: Gynecologic Oncology Unit, Obstetrics and Gynecology Clinical Management Unit, Araba University Hospital Osakidetza, Basque Public Health Service, Vitoria, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Cuadra
authors.affiliation: Gynecologic Oncology Unit, Obstetrics and Gynecology Clinical Management Unit, Araba University Hospital Osakidetza, Basque Public Health Service, Vitoria, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Mendizabal
authors.affiliation: Gynecologic Oncology Unit, Obstetrics and Gynecology Clinical Management Unit, Araba University Hospital Osakidetza, Basque Public Health Service, Vitoria, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Gorostiaga
authors.affiliation: Gynecologic Oncology Unit, Obstetrics and Gynecology Clinical Management Unit, Araba University Hospital Osakidetza, Basque Public Health Service, Vitoria, Spain. Electronic address: luisignacio.letelasa@osakidetza.net.
authors.forename: Iñaki
authors.initials: I
authors.lastname: Lete
mesh_terms: D000367:Age Factors; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D000066491:Clinical Decision-Making / Q000379:methods*; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008207:Lymphatic Metastasis; D008408:Mastectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D011182:Postoperative Care / Q000379:methods*; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D000071036:Sentinel Lymph Node / Q000473:pathology; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*
keywords: Intraoperative breast cancer; Selective sentinel lymph node biopsy; Sensitivity; Specificity