Application of fluorescent immunocytochemistry in intraoperative diagnostics of metastases in sentinel lymph nodes in early breast cancer.

Abstract

The aim of the study was to show the possibilities of fluorescent immunocytochemistry in urgent intraoperative examination of sentinel lymph nodes in patients with early breast cancer. The authors analyzed the data on the state of the lymph nodes in 94 patients with early breast cancer who had been operated on since December 2016 to January 2018 in the Department of reconstructive plastic surgery of the breast and skin of the P.A. Herzen Moscow Oncological Institute. As a result of the use of the «Tekhnefit99ᵐTc» radiopharmaceutical during the operation, sentinel lymph nodes were isolated, the state of which was assessed by the method of urgent intraoperative cytology. In difficult-to-diagnose cases, fluorescent immunocytochemistry was used, which made it possible to avoid hypo- and overdiagnosis in 30 patients with early breast cancer. The sensitivity of the urgent cytological method for examining the sentinel lymph nodes smears was 83.3%, the specificity - 100%, the efficiency -83%, the predictive value of a positive result - 83.3%, and the predictive value of a negative result - 100%. Thus, the diagnostic accuracy of urgent cytological examination of the sentinel lymph node was 94%.