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90th Annual Meeting Abstracts


The Value Of Intraoperative Frozen Section Examination In Sentinel Lymph Node Biopsy For Breast Cancer
*SHOHAN SHETTY, MD, MICHAEL AJEMIAN, MD, FACS, *JOSE MARIO PIMIENTO, MD
ST MARY'S HOSPITAL, WATERBURY, CT

Objective:
Introperative frozen section (IFS) examination in Sentinel lymph node biopsy (SLNB) has been effective in detecting metastatic breast disease allowing for immediate (single stage) axillary lymph node dissection (ALND). A false negative result is however associated with IFS, most often due to a failure to detect micrometastases. The purpose of our study was to evaluate the initial experience in performing SLNB in our hospital and the value of performing an IFS during SLNB.
Design:
Retrospective review
Setting:
St Mary's Hospital Waterbury Patients: All patients with breast cancer who underwent sentinel lymph node biopsy
Interventions:
Main Outcome Measures:
Results:
SLNB was performed in 141 patients from January 2002 to December 2007. The mean age of the patient was 58.7 years (+-0.98y). The mean number of sentinel lymph nodes was 2.397 (+-0.16). SLNB was completed in 99.5% of patients. ALND was performed in 100% (2/2) of patients in whom SLNB could not be completed. IFS was negative in 123 (89%) patients. A false negative IFS was seen in 9 (7%) patients. PPV of IFS was 100%. NPV was 92%. The final pathology was negative in 117 (83%) patients. Completion ALND was performed on 22% of patients with a false negative IFS corresponding to 1.7% of all patients with a negative IFS. An IFS on the sentinel lymph node was not requested in 7 (5%) patients. Completion ALND was performed on 28% of patients who did not have an IFS requested during SLNB
Conclusions:
Performing IFS in this patient population is an effective way to avoid a two stage operative procedure and should be considered an adjunct to SLNB


 

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