FROZEN SECTION EXAMINATION OF SENTINEL LYMPH NODE IN EARLY BREAST CANCER

Aim: Sentinel lymph node biopsy (SLNB) is an alternative to axillary lymph node dissection (ALND) in patients with early breast cancer. Objective of this study is to determine feasibility, accuracy of frozen section (FS) in (SNLB) using different techniques. Methods: A review of 61 patients with breast cancer (stage I, II), undergoing SLNB in Department of Surgery, King Abdulaziz University and Bakhsh Hospitals during (December 2000 - 2005).SLNB was localized using methylene blue (n=27), lymphazorine (n=25), radioisotope (n=3) or combination of lymphazorine radioisotope (n=4) and methylene blue radioisotope (n=2). Overall results were analyzed. Sentinel lymph nodes (SLN), non sentinel lymph nodes (NSLN) were analyzed using haematoxylin-eosin; immunohistochemical staining and results were compared. Results: SLN identification rates were 100%. 77.0% of patients had stage I and 23.0% had stage II breast cancer. Positive SLN, NSLN, total axillary lymph node (TALN) were (19.7%, 18.0%, 23.0%) with false negative rate of SLN 3.3%. 77.00% of patients had breast conserving therapy while 23.0% had mastectomy. FS accuracy, sensitivity, specificity, positive and negative predictive values were (96.7%, 85.7%, 100.0%, 100.0%, 95.9%).Local breast recurrence rate was 3.3%. Conclusion: SLNB should be offered in patients with early breast cancers because of high detection rate, accurate staging and minimal morbidity. FS examination allowed synchronous ALND to be performed in patients with positive SLNB at our institution