Efficiency of imaging and frozen section in analysis of sentinel lymph node biopsy in early breast cancer
Sumitha Vinoth Kumar, Nandini Govindarajan, Geetha Priya Sivaramalingam, Debashri Shankarraman, Selvi Radha KrishnaObjectives:
A retrospective study on false negative sentinel lymph node biopsies that were positive on final histopathology with ultrasonography (USG) imaging, and positron emission tomography-computed tomography (PET/CT) correlation of the respective axillary lymph nodes.
Materials and Methods:
This is a retrospective study of frozen biopsy on the sentinel lymph node in a single center, which was carried out in 518 early breast cancer cases for a period of 5 years. Especially, false negative lymph nodes were included and compared with USG imaging and PET/CT reports.
Results:
Out of 518 sentinel lymph node biopsies performed, 23 showed frozen and final histopathology discordance, resulting in false-negative cases in frozen section. Out of the 23 cases, the PET CT study revealed 5 faint FDG-avid, 13 non-FDG-avid, and 4 FDG-avid results. And in one case, PET CT was not done. Out of 23, 7 nodes showed eccentric cortical thickening on USG.
Conclusion:
Intraoperative frozen section evaluation of sentinel lymph node biopsy in breast cancer enables more efficient and accurate axillary staging. The imaging modalities PET CT and USG identify suspicious lymph nodes and aid in the diagnosis of metastases, and therefore, A multimodal approach always has high diagnostic accuracy.