Value of the intraoperative cytology examination of sentinel lymph node in breast cancer
Keywords:
Sentinel lymph node, breast cancer, cell biologyAbstract
Objective: Evaluate the value of imprint cytology in the intraoperative analysis of sentinel lymph node (SLN) in patients with breast cancer. Methods: An agreement study for the evaluation of the imprint cytology technique as a diagnostic test for intraoperative SLN among patients diagnosed with breast cancer from January 2007 to January 2017. Results: We studied 210 cases of breast cancer patients submitted to intraoperative sentinel node imprint cytology, aged between 24 and 86 years (mean age 59 years and median age 60 years). The sensitivity of the intraoperative study was 58.3% (95%CI 46.1–69.8%) and the specificity was 97.8% (95%CI 93.8–99.5). The positive predictive value (PPV) was 93.3% (95%CI 81.7–98.6) and the negative predictive value (NPV) was 81.8% (95%CI 75.1–87.4). From the analyzed variables, the presence of macrometastasis was the only one that significantly increased the sensitivity of the imprint to 73.2% (95%CI 59.7–84.2), while micrometastasis presented a sensitivity of only 6.3% (95%CI 0.2–30.2). Conclusion: The use of imprint cytology in the intraoperative SLN study showed good accuracy in predicting axillary status. However, the surgeon and pathologist are fully aware of the set of clinical and histological variables that can influence the sensitivity of the method.
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Copyright (c) 2018 Talita Siemann Santos Pereira, Guilherme Loureiro Werneck, Henrique de Castro Rodrigues, Ana Helena Pereira Correia, Afrânio Coelho de Oliveira
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