Abstract
Abstract
Background
Accurate staging and proper management of axillary lymph nodes (ALNs) in breast cancer patients are important for treatment. Surgical management of the axilla has evolved greatly in the last 20 years. Sentinel lymph node biopsy (SLNB), which was first investigated in the early 1990s, has replaced routine axillary lymph node dissection. This study evaluates the capability of using an ultrasound (US) as an alternative tool for the frozen section in the assessment of the ex vivo sentinel lymph node biopsy in countries with limited resources.
Results
The study is a prospective study that included 216 female patients with early breast cancer and negative axillary lymph nodes. All excised lymph nodes were examined by the intraoperative US and frozen section examinations. All the results were correlated with the final histopathological results. The number of negative nodes by US, frozen, and paraffin section examination was 58.30%, 69.40%, and 69.40%, respectively. The number of positive nodes by the US, frozen, and paraffin section examinations was 41.70%, 30.60%, and 30.60% respectively. The sensitivity, specificity, PPV, NPV, and accuracy of US in the detection of positive lymph nodes were 95.45%, 82%, 70%, 97.62%, and 86.11%, respectively, and the sensitivity, specificity, PPV, NPV, and accuracy of frozen examination in the detection of positive lymph nodes were 90.91%, 96%, 90.91%, 96%, and 94.44%, respectively.
Conclusion
Intraoperative US is a good negative test in the assessment of ex vivo SLNB, but it is not a good positive test, so it cannot replace the intraoperative frozen section in the assessment of SLNs.
Publisher
Springer Science and Business Media LLC
Subject
Radiology, Nuclear Medicine and imaging
Reference19 articles.
1. Alkuwari E, Auger M (2008) Accuracy of fine-needle aspiration cytology of axillary lymph nodes in breast cancer patients. A study of 115 cases with cytologic –histologic correlation. Am Cancer Soc 114:89–93
2. Siguan SS, Bordeos LN, Baking-Fernandez STA (2016) A review of the accuracy of sentinel lymph node biopsy by comparing frozen section with final paraffin block H&S staining and correlation with the final axillary lymph node dissection results. Philipp J Surg Specialists (PJSS) 71:41–45
3. Van der Noordaa MEM, Peeters V, Rutgers EJT (2017) The intraoperative assessment of sentinel nodes –standard and controversies. Breast 34:64–69
4. Giuliano AE, Hunt KK, Ballman KV, Beitsch PD, Whitworth PW et al (2011) Axillary dissection vs. no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA 9:569–575
5. Galen RS (1980) Predictive values and efficiency of laboratory testing. Pediat J Clin North Am 27:861–869
Cited by
3 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献