New England Surgical Society (NESS)
Search NESS
  Home
  Annual Meeting
  Annual Resident and Fellow Research Day
  Members
      Member Directory
      Members Only
  Scholars Foundation
  Job Board
  Awards
  Journal of the American College of Surgeons
  Newsletters
  Committees
  Contact NESS

2010 Annual Meeting Abstracts

Back to Program


The Accuracy of Intraoperative Frozen Section Analysis of Sentinel Lymph Node Biopsy for Breast Cancer over a Seven-Year Period
*Brigid K Killelea, Baiba J Grube, *Mohammad Rishi, Donald R. Lannin
Yale University, New Haven, CT

Objective: Sentinel lymph node biopsy (SLNB) with intraoperative frozen section (FS) has been accepted for evaluation of the axilla in breast cancer patients. The objective of this study was to determine the false negative rate of FS of the SLN over a 7-year period and to identify the size of metastases, e.g., macrometastases, micrometastases, or isolated tumor cells (ITCs) that were missed on frozen section. The secondary aim was to determine the subsequent axillary management.

Methods: A retrospective review was performed of all patients who underwent SLNB between July, 2002 and December, 2009. Results from FS were compared to the final pathologic diagnosis to characterize false negative findings. The number of patients who underwent axillary lymph node dissection (ALND), as well as the number with additional positive NSLNs was determined.

Results: See tables 1 and 2
Conclusions: FS analysis of the SLN is a highly accurate procedure and resulted in a low false negative rate, and definitive axillary surgery in 99%. The majority of the false negatives were ITCs or micromets, which depending on practice patterns, may not be a clinically important detriment.
Table 1. FS Analysis
Permanent Results
PositiveNegativeTotal
Frozen Section AnalysisMacrometsmicrometsITCs
Positive158930170
Negative81430746798
Total1662333746968

Table 2. Axillary Management
no. of cases where ALND was doneno. cases with additional non-SLNs positiveNo. cases observedTotal
true positive SN by FS170/170 (100%)84/170 (49%)0170
False negative FS52
Macro6/8 (75%)1/6 (17%)28
Micro6/14 (43%)1/6 (17%)814
ITCs1/30 (3%)02930
Total18339222


Back to Program

 

Copyright © 2018 New England Surgical Society. All Rights Reserved.
Read Privacy Policy.