TY - JOUR AU - Tolentino-Molina, Maria Kariza Laqui AU - Datay-Lim, Sarah Jane AU - Alcazaren, Elizabeth Ann PY - 2016/04/26 Y2 - 2024/03/28 TI - Intraoperative Frozen Section Assessment of Sentinel Lymph Nodes in Breast Cancer: Six-Year Experience in a Tertiary Hospital JF - PJP JA - Phil Journal Path VL - 1 IS - 1 SE - Original Articles DO - 10.21141/PJP.2016.006 UR - https://philippinejournalofpathology.org/index.php/PJP/article/view/26 SP - 15-19 AB - <p><strong><span style="font-size: medium;">Objective. </span></strong><span style="font-size: medium;">To determine the reliability of intraoperative frozen section (FS) assessment of sentinel lymph nodes (SLN) in breast cancer patients and describe the factors affecting its evaluation.</span></p><p><strong><span style="font-size: medium;">Methodology.  </span></strong><span style="font-size: medium;">Records of 245 breast cancer patients with FS of SLNs from December 2007 to December 2013 were retrieved and analyzed. The effect of discordant FS examination and pathology findings on axillary lymph node dissection (ALND) was then evaluated.</span></p><p><strong><span style="font-size: medium;">Results. </span></strong><span style="font-size: medium;">Of the</span><span style="font-size: medium;"> total 616 SLNs </span><span style="font-size: medium;">evaluated,</span><span style="font-size: medium;"> 85 (13.80%) SLNs were positive on FS, with the majority having </span><span style="font-size: medium;">a histological diagnosis of</span><span style="font-size: medium;"> invasive ductal carcinoma of no special type (62.04%). Overall identification rate was 98.36%. Frozen section biopsies had good correlation with permanent sections, with a sensitivity (Sn) of 92.39%, specificity (Sp) of 100%, and a positive predictive value (PPV) of 100%. Negative cases on FS but were found positive on permanent sections were all cases of micrometastases, giving a false negative rate of 1.31% and negative predictive value (NPV) of 98.68%. Validation with ALND showed Sn of 100%, Sp of 50%, NPV of 100%, and PPV of 37.17%.</span></p><p><strong><span style="font-size: medium;">Conclusion. </span></strong><span style="font-size: medium;">The 6 year data on intraoperative FS reliably evaluated the SLN status of breast cancer patients with a negligible false negative rate. Factors affecting its effectiveness include the predictors of nodal involvement, multilevel sectioning, and size of metastases.</span></p> ER -