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Intraoperative touch imprint cytology for the diagnosis of sentinel lymph node metastases in breast cancer

Intraoperative touch imprint cytology for the diagnosis of sentinel lymph node metastases in breast cancer
Intraoperative touch imprint cytology for the diagnosis of sentinel lymph node metastases in breast cancer
Background: Intraoperative detection of sentinel lymph node (SLN) metastases enables the surgeon to take an immediate decision to proceed to completion axillary lymph node dissection (ALND). The aim of this study was to determine the accuracy of touch imprint cytology (TIC) for the diagnosis of SLN metastases in sentinel nodes from women with breast cancer.
Methods: Touch imprints from 235 sentinel nodes in 133 women with breast cancer were diagnosed by cytopathology and compared with definitive histopathology results. After a feasibility study, a real-time study was performed with the surgeon proceeding to ALND based on the TIC diagnosis. The clinical opinion of the operating surgeon as to whether the SLN appeared to contain metastases was recorded, as was the time taken for the result to be available.
Results: TIC detected metastases with a sensitivity of 81·1 per cent and a specificity of 100 per cent. False-negative TIC diagnoses were associated with micrometastases and lobular carcinoma. The majority of false-negative diagnoses were due to sampling rather than interpretation errors. Clinical assessment of sentinel nodes had a sensitivity of 64·3 per cent and a specificity of 87·6 per cent.
Conclusion: TIC is feasible and enables the rapid diagnosis of SLN metastases with an acceptable accuracy for clinical use in ductal carcinoma of the breast.
572-576
Chicken, D.W.
2d5d9dde-8a90-4bcc-9111-460e549e75b4
Kocjan, G.
8b04c4f3-1781-40a9-b055-0130c31e0d68
Falzon, M.
e024cb8f-e343-40dc-bf3a-6968eea39a75
Lee, A.C.
302f6247-8e92-4b16-9a9f-aa410bb4c10c
Douek, M.
4850ae23-4e49-4a8d-b42d-eec70801f522
Sainsbury, R.
f6c9f95c-7dda-48de-a4bc-3a7c00e09eef
Keshtgar, M.R.S.
63fec5ae-22b5-490c-8d70-a4dbc1e41814
Chicken, D.W.
2d5d9dde-8a90-4bcc-9111-460e549e75b4
Kocjan, G.
8b04c4f3-1781-40a9-b055-0130c31e0d68
Falzon, M.
e024cb8f-e343-40dc-bf3a-6968eea39a75
Lee, A.C.
302f6247-8e92-4b16-9a9f-aa410bb4c10c
Douek, M.
4850ae23-4e49-4a8d-b42d-eec70801f522
Sainsbury, R.
f6c9f95c-7dda-48de-a4bc-3a7c00e09eef
Keshtgar, M.R.S.
63fec5ae-22b5-490c-8d70-a4dbc1e41814

Chicken, D.W., Kocjan, G., Falzon, M., Lee, A.C., Douek, M., Sainsbury, R. and Keshtgar, M.R.S. (2006) Intraoperative touch imprint cytology for the diagnosis of sentinel lymph node metastases in breast cancer. British Journal of Surgery, 93 (5), 572-576. (doi:10.1002/bjs.5289).

Record type: Article

Abstract

Background: Intraoperative detection of sentinel lymph node (SLN) metastases enables the surgeon to take an immediate decision to proceed to completion axillary lymph node dissection (ALND). The aim of this study was to determine the accuracy of touch imprint cytology (TIC) for the diagnosis of SLN metastases in sentinel nodes from women with breast cancer.
Methods: Touch imprints from 235 sentinel nodes in 133 women with breast cancer were diagnosed by cytopathology and compared with definitive histopathology results. After a feasibility study, a real-time study was performed with the surgeon proceeding to ALND based on the TIC diagnosis. The clinical opinion of the operating surgeon as to whether the SLN appeared to contain metastases was recorded, as was the time taken for the result to be available.
Results: TIC detected metastases with a sensitivity of 81·1 per cent and a specificity of 100 per cent. False-negative TIC diagnoses were associated with micrometastases and lobular carcinoma. The majority of false-negative diagnoses were due to sampling rather than interpretation errors. Clinical assessment of sentinel nodes had a sensitivity of 64·3 per cent and a specificity of 87·6 per cent.
Conclusion: TIC is feasible and enables the rapid diagnosis of SLN metastases with an acceptable accuracy for clinical use in ductal carcinoma of the breast.

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Published date: 21 March 2006

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Local EPrints ID: 49326
URI: http://eprints.soton.ac.uk/id/eprint/49326
PURE UUID: f13cf8ed-fa39-4332-a1a9-fcaad6c9f2fd

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Date deposited: 30 Oct 2007
Last modified: 15 Mar 2024 09:55

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Contributors

Author: D.W. Chicken
Author: G. Kocjan
Author: M. Falzon
Author: A.C. Lee
Author: M. Douek
Author: R. Sainsbury
Author: M.R.S. Keshtgar

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