Is the frozen section examination for sentinel lymph node necessary in early breast cancer patients?

Kwang Hyun Yoon, Seho Park, Jee Ye Kim, Hyung Seok Park, Seung Il Kim, Young Up Cho, Byeong Woo Park

Research output: Contribution to journalArticle

Abstract

Purpose: Sentinel lymph node (SLN) biopsy (SLNB) is widely performed for axillary staging in patients with breast cancer. Based on the results of frozen section examination (FSE), surgeons can decide to continue further axillary dissections. This study aimed to verify the accuracy of FSE for SLNs. Methods: We reviewed the records of 4,219 patients who underwent SLNB for primary invasive breast cancer between 2007 and 2016 at the Severance Hospital. We evaluated factors associated with the false-negative results of FSE for SLNs using the Generalized Estimating Equations model. Results: A total of 1,397 SLNs from 908 patients were confirmed to be metastatic. Seventy-one patients (1.7%) had confirmed pathologic N2 or N3 stage. Among metastatic SLNs, micrometastasis was found in 234 (16.8%). The overall accuracy of SLNB was 98.5%. The sensitivity and false-negative rate of FSE were 86.4% and 13.6%, respectively. Several clinicopathological factors, including the size of SLN metastases, suspicious preoperative axillary lymph nodes, and luminal B subtype, were associated with a higher rate of false-negative results. Conclusion: Most patients were not indicated for axillary lymph node dissection. Some patients may show transition in their permanent pathology due to the size of the metastatic node. However, the false-negative results of FSE for SLNs based on the size of the metastatic node did not change our practice. Therefore, intraoperative FSE for SLN should not be routinely performed for all breast cancer patients.

Original languageEnglish
Pages (from-to)49-57
Number of pages9
JournalAnnals of Surgical Treatment and Research
Volume97
Issue number2
DOIs
Publication statusPublished - 2019 Jan 1

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Frozen Sections
Breast Neoplasms
Biopsy
Sentinel Lymph Node Biopsy
Neoplasm Micrometastasis
Sentinel Lymph Node
Lymph Node Excision
Dissection
Lymph Nodes
Pathology
Neoplasm Metastasis

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Yoon, Kwang Hyun ; Park, Seho ; Kim, Jee Ye ; Park, Hyung Seok ; Kim, Seung Il ; Cho, Young Up ; Park, Byeong Woo. / Is the frozen section examination for sentinel lymph node necessary in early breast cancer patients?. In: Annals of Surgical Treatment and Research. 2019 ; Vol. 97, No. 2. pp. 49-57.
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title = "Is the frozen section examination for sentinel lymph node necessary in early breast cancer patients?",
abstract = "Purpose: Sentinel lymph node (SLN) biopsy (SLNB) is widely performed for axillary staging in patients with breast cancer. Based on the results of frozen section examination (FSE), surgeons can decide to continue further axillary dissections. This study aimed to verify the accuracy of FSE for SLNs. Methods: We reviewed the records of 4,219 patients who underwent SLNB for primary invasive breast cancer between 2007 and 2016 at the Severance Hospital. We evaluated factors associated with the false-negative results of FSE for SLNs using the Generalized Estimating Equations model. Results: A total of 1,397 SLNs from 908 patients were confirmed to be metastatic. Seventy-one patients (1.7{\%}) had confirmed pathologic N2 or N3 stage. Among metastatic SLNs, micrometastasis was found in 234 (16.8{\%}). The overall accuracy of SLNB was 98.5{\%}. The sensitivity and false-negative rate of FSE were 86.4{\%} and 13.6{\%}, respectively. Several clinicopathological factors, including the size of SLN metastases, suspicious preoperative axillary lymph nodes, and luminal B subtype, were associated with a higher rate of false-negative results. Conclusion: Most patients were not indicated for axillary lymph node dissection. Some patients may show transition in their permanent pathology due to the size of the metastatic node. However, the false-negative results of FSE for SLNs based on the size of the metastatic node did not change our practice. Therefore, intraoperative FSE for SLN should not be routinely performed for all breast cancer patients.",
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Is the frozen section examination for sentinel lymph node necessary in early breast cancer patients? / Yoon, Kwang Hyun; Park, Seho; Kim, Jee Ye; Park, Hyung Seok; Kim, Seung Il; Cho, Young Up; Park, Byeong Woo.

In: Annals of Surgical Treatment and Research, Vol. 97, No. 2, 01.01.2019, p. 49-57.

Research output: Contribution to journalArticle

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AU - Kim, Seung Il

AU - Cho, Young Up

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