Intraoperative touch imprint and frozen section analysis of sentinel lymph nodes after neoadjuvant chemotherapy for breast cancer

Ian K. Komenaka, Rozbeh Torabi, Geetha Nair, Lakshmi Jayaram, Chiu-Hsieh Hsu, Marcia E. Bouton, Harikrishna Dave, Dan Hobohm

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Objective: To evaluate the accuracy of touch imprint and frozen section analysis of sentinel nodes after neoadjuvant chemotherapy. Summary Background Data: Intraoperative evaluation of the sentinel node can determine the need for axillary dissection at the time of initial operation and therefore spare the patient a second operation. Little data, however, exists on the accuracy of intraoperative evaluation of sentinel nodes after neoadjuvant chemotherapy. Methods: A retrospective chart review was performed of all sentinel node procedures for breast cancer from 2004 to 2008 at a single institution. The sentinel node procedure was done before (no-NACT) chemotherapy in 107 patients and 37 had the procedure after neoadjuvant (NACT) chemotherapy. Intraoperative analysis of sentinel nodes was performed using touch imprint and frozen section techniques. Results: In the no-NACT group, intraoperative assessment by touch imprint analysis had 61% sensitivity, 100% specificity, and 87% accuracy. Frozen section analysis was similar with 74% sensitivity, 100% specificity, and 90% accuracy. In the NACT group, touch imprint analysis had 79% sensitivity, 100% specificity, and 90% accuracy. Frozen section analysis was again similar with 74% sensitivity, 100% specificity, and 83% accuracy. When the no-NACT group and the NACT group were compared, both frozen section and touch imprint analysis had similar sensitivity, specificity, and accuracy. Conclusions: Intraoperative evaluation of sentinel nodes with touch imprint and frozen section analysis in patients treated with neoadjuvant chemotherapy showed acceptable sensitivity, specificity, and accuracy. Nearly all of the misses in intraoperative evaluation were in patients with micrometastases.

Original languageEnglish (US)
Pages (from-to)319-322
Number of pages4
JournalAnnals of Surgery
Volume251
Issue number2
DOIs
StatePublished - Feb 2010

Fingerprint

Touch
Frozen Sections
Breast Neoplasms
Drug Therapy
Sensitivity and Specificity
Neoplasm Micrometastasis
cyhalothrin
Sentinel Lymph Node
Dissection

ASJC Scopus subject areas

  • Surgery

Cite this

Intraoperative touch imprint and frozen section analysis of sentinel lymph nodes after neoadjuvant chemotherapy for breast cancer. / Komenaka, Ian K.; Torabi, Rozbeh; Nair, Geetha; Jayaram, Lakshmi; Hsu, Chiu-Hsieh; Bouton, Marcia E.; Dave, Harikrishna; Hobohm, Dan.

In: Annals of Surgery, Vol. 251, No. 2, 02.2010, p. 319-322.

Research output: Contribution to journalArticle

Komenaka, Ian K. ; Torabi, Rozbeh ; Nair, Geetha ; Jayaram, Lakshmi ; Hsu, Chiu-Hsieh ; Bouton, Marcia E. ; Dave, Harikrishna ; Hobohm, Dan. / Intraoperative touch imprint and frozen section analysis of sentinel lymph nodes after neoadjuvant chemotherapy for breast cancer. In: Annals of Surgery. 2010 ; Vol. 251, No. 2. pp. 319-322.
@article{0473cebeecdb4c21922ca7c5fff2955f,
title = "Intraoperative touch imprint and frozen section analysis of sentinel lymph nodes after neoadjuvant chemotherapy for breast cancer",
abstract = "Objective: To evaluate the accuracy of touch imprint and frozen section analysis of sentinel nodes after neoadjuvant chemotherapy. Summary Background Data: Intraoperative evaluation of the sentinel node can determine the need for axillary dissection at the time of initial operation and therefore spare the patient a second operation. Little data, however, exists on the accuracy of intraoperative evaluation of sentinel nodes after neoadjuvant chemotherapy. Methods: A retrospective chart review was performed of all sentinel node procedures for breast cancer from 2004 to 2008 at a single institution. The sentinel node procedure was done before (no-NACT) chemotherapy in 107 patients and 37 had the procedure after neoadjuvant (NACT) chemotherapy. Intraoperative analysis of sentinel nodes was performed using touch imprint and frozen section techniques. Results: In the no-NACT group, intraoperative assessment by touch imprint analysis had 61{\%} sensitivity, 100{\%} specificity, and 87{\%} accuracy. Frozen section analysis was similar with 74{\%} sensitivity, 100{\%} specificity, and 90{\%} accuracy. In the NACT group, touch imprint analysis had 79{\%} sensitivity, 100{\%} specificity, and 90{\%} accuracy. Frozen section analysis was again similar with 74{\%} sensitivity, 100{\%} specificity, and 83{\%} accuracy. When the no-NACT group and the NACT group were compared, both frozen section and touch imprint analysis had similar sensitivity, specificity, and accuracy. Conclusions: Intraoperative evaluation of sentinel nodes with touch imprint and frozen section analysis in patients treated with neoadjuvant chemotherapy showed acceptable sensitivity, specificity, and accuracy. Nearly all of the misses in intraoperative evaluation were in patients with micrometastases.",
author = "Komenaka, {Ian K.} and Rozbeh Torabi and Geetha Nair and Lakshmi Jayaram and Chiu-Hsieh Hsu and Bouton, {Marcia E.} and Harikrishna Dave and Dan Hobohm",
year = "2010",
month = "2",
doi = "10.1097/SLA.0b013e3181ba845c",
language = "English (US)",
volume = "251",
pages = "319--322",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Intraoperative touch imprint and frozen section analysis of sentinel lymph nodes after neoadjuvant chemotherapy for breast cancer

AU - Komenaka, Ian K.

AU - Torabi, Rozbeh

AU - Nair, Geetha

AU - Jayaram, Lakshmi

AU - Hsu, Chiu-Hsieh

AU - Bouton, Marcia E.

AU - Dave, Harikrishna

AU - Hobohm, Dan

PY - 2010/2

Y1 - 2010/2

N2 - Objective: To evaluate the accuracy of touch imprint and frozen section analysis of sentinel nodes after neoadjuvant chemotherapy. Summary Background Data: Intraoperative evaluation of the sentinel node can determine the need for axillary dissection at the time of initial operation and therefore spare the patient a second operation. Little data, however, exists on the accuracy of intraoperative evaluation of sentinel nodes after neoadjuvant chemotherapy. Methods: A retrospective chart review was performed of all sentinel node procedures for breast cancer from 2004 to 2008 at a single institution. The sentinel node procedure was done before (no-NACT) chemotherapy in 107 patients and 37 had the procedure after neoadjuvant (NACT) chemotherapy. Intraoperative analysis of sentinel nodes was performed using touch imprint and frozen section techniques. Results: In the no-NACT group, intraoperative assessment by touch imprint analysis had 61% sensitivity, 100% specificity, and 87% accuracy. Frozen section analysis was similar with 74% sensitivity, 100% specificity, and 90% accuracy. In the NACT group, touch imprint analysis had 79% sensitivity, 100% specificity, and 90% accuracy. Frozen section analysis was again similar with 74% sensitivity, 100% specificity, and 83% accuracy. When the no-NACT group and the NACT group were compared, both frozen section and touch imprint analysis had similar sensitivity, specificity, and accuracy. Conclusions: Intraoperative evaluation of sentinel nodes with touch imprint and frozen section analysis in patients treated with neoadjuvant chemotherapy showed acceptable sensitivity, specificity, and accuracy. Nearly all of the misses in intraoperative evaluation were in patients with micrometastases.

AB - Objective: To evaluate the accuracy of touch imprint and frozen section analysis of sentinel nodes after neoadjuvant chemotherapy. Summary Background Data: Intraoperative evaluation of the sentinel node can determine the need for axillary dissection at the time of initial operation and therefore spare the patient a second operation. Little data, however, exists on the accuracy of intraoperative evaluation of sentinel nodes after neoadjuvant chemotherapy. Methods: A retrospective chart review was performed of all sentinel node procedures for breast cancer from 2004 to 2008 at a single institution. The sentinel node procedure was done before (no-NACT) chemotherapy in 107 patients and 37 had the procedure after neoadjuvant (NACT) chemotherapy. Intraoperative analysis of sentinel nodes was performed using touch imprint and frozen section techniques. Results: In the no-NACT group, intraoperative assessment by touch imprint analysis had 61% sensitivity, 100% specificity, and 87% accuracy. Frozen section analysis was similar with 74% sensitivity, 100% specificity, and 90% accuracy. In the NACT group, touch imprint analysis had 79% sensitivity, 100% specificity, and 90% accuracy. Frozen section analysis was again similar with 74% sensitivity, 100% specificity, and 83% accuracy. When the no-NACT group and the NACT group were compared, both frozen section and touch imprint analysis had similar sensitivity, specificity, and accuracy. Conclusions: Intraoperative evaluation of sentinel nodes with touch imprint and frozen section analysis in patients treated with neoadjuvant chemotherapy showed acceptable sensitivity, specificity, and accuracy. Nearly all of the misses in intraoperative evaluation were in patients with micrometastases.

UR - http://www.scopus.com/inward/record.url?scp=77449132875&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77449132875&partnerID=8YFLogxK

U2 - 10.1097/SLA.0b013e3181ba845c

DO - 10.1097/SLA.0b013e3181ba845c

M3 - Article

C2 - 19864940

AN - SCOPUS:77449132875

VL - 251

SP - 319

EP - 322

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 2

ER -