Sentinel Lymph Node Biopsy (SLNB) is the standard of care for axillary staging in breast cancer. Multiple Step-section Frozen Section (MSFS) analysis is used in our institution for SLNB. This is performed intra-operatively by freezing sentinel lymph nodes to obtain multiple step-sections which are examined histologically for evidence of metastases. Patients whose sentinel lymph nodes contained macrometastases proceeded to an axillary node clearance during the same operation. 717 patients over a two and a half year period had MSFS analysis. With regards to macrometastases, MSFS analysis had a sensitivity of 93.8%, a specificity of 99.3%, a positive-predictive value of 97.4% and a negative-predictive value of 98.2%. MSFS analysis of sentinel lymph nodes is a safe and accurate procedure. It is a relatively cost-effective alternative to molecular technologies relying on DNA amplification and more accurate than standard frozen section or touch-prep cytology.
Keywords: ALND; Breast cancer; DCIS; Frozen section; MSFS; Multiple Step-section Frozen Section; OSNA; One Step Nucleic Acid Amplification; RT-PCR; Reverse Transcriptase Polymerase Chain Reaction; SLN; Sentinel node biopsy; WLE; axillary lymph node dissection; ductal carcinoma in-situ; sentinel lymph node; wide local excision.
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