Intraoperative axillary sentinel lymph node touch imprints lack sensitivity in detecting metastatic breast carcinoma

C. E. Litz, P. D. Beitsch, E. Clifford, C. A. Roberts, G. Ewing

Research output: Contribution to journalArticle

Abstract

Background: Intraoperative axillary sentinel lymph node (SN) touch preparation cytology has been considered sensitive for detecting metastatic breast carcinoma. This prospective study was undertaken to assess the sensitivity of touch preparation cytology (TPC) in a routine setting. Design: Intraoperative TPC was performed on 207 SN from 96 patients; 87 diagnosed with invasive ductal carcinoma, 8 with invasive lobular carcinoma, and 1 with carcinoid tumor of the breast. TPC was performed according to Rubio et al (Ann Surg Oncol 5:689, 1998). Positive TPC diagnoses resulted in immediate axillary dissections. Subsequent SN permanent section evaluation included serial step sections. Cytokeratin immunohistochemical staining was performed on morphologically negative cases. Results: Of the 207 intraoperative TPC, 10 were positive and 197 were negative for carcinoma. Permanent section analysis confirmed the presence of carcinoma in TPC positive cases and documented carcinoma in 19 of the TPC negative SNs. Sensitivity and specificity for TPC of SN in the detection of metastatic carcinoma was 34% and 100%, respectively. False negative intraoperative TPC diagnoses were found when the SN contained 1) occult micrometastases (12 of 19 cases) in which tumor presumably was not imprinted and 2) metastatic lobular carcinoma (5 of 19 cases) in which confidant distinction of malignant cells from lymphoid cells was not possible. Conclusion: Intraoperative sentinel lymph node touch preparation cytology can be helpful to confirm gross (clinically suspicious) metastases but is not sensitive in detecting micrometastatic and lobular carcinoma.

Original languageEnglish (US)
Number of pages1
JournalBreast Cancer Research and Treatment
Volume69
Issue number3
StatePublished - Dec 1 2001

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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