篇名 |
Intra-operative Frozen Section for Sentinel Lymph Node: a Pathologic Study of 262 Patients with Breast Cancer |
作者 |
Ren-Ching Wang, Yee-Jee Jan, John Wang, Dah-Cherng Yeh, Cheng-Chung Wu |
卷期/出版年月 |
39卷2期 (2006/4) |
頁次 |
66-71 |
摘要 |
Background: Sentinel lymph node biopsy (SLNB) has been developed for
assessment of the staging of breast cancer patients to minimize the morbidity of complete
axillary lymph node dissection (ALND). This study evaluates the sensitivity and
specificity of intra-operative frozen section (FS) examination of sentinel lymph node
biopsy.
Materials and Methods: Between January 2000 and February 2004, samples were
collected from breast cancer patients at the Taichung Veterans General Hospital who
underwent intra-operative FS for SLNB. The frozen tissue also underwent standard
paraffin tissue processing afterwards and the result of each paraffin section was
regarded as the gold standard of intra-operative FS.
Results: A total of 952 sentinel lymph nodes from 262 patients were harvested. The
overall sensitivity and specificity for intra-operative FS were 68.6% (72/105) and
99.6% (844/847) respectively. When further stratified according to metastatic size, the
sensitivity for macrometastases, micrometastases, and submicrometastases were
95.5% (64/67), 25% (6/24), and 14.3% (2/14) respectively.
Conclusions: Intra-operative FS of SLNB is a highly specific and sensitive method
for detecting macrometastases, while showing high specificity and low sensitivity for
micrometastases and submicrometastases. For such metastases, more precise methods
may help in accurate diagnosis. Following studies of the histological sections of negative
sentinel nodes after using frozen sections are necessary to find occult metastases,
and a two-step operation is essential for such patients. |
關鍵詞 |
axillary lymph node, breast cancer, intra-operative frozen section, sentinel lymph node biopsy (SLNB) |
分類 |
Original Article |