Abstract
Sentinel lymph node biopsy (SLNB) is now known to offer an excellent alternative method to routine axillary lymph node dissection in staging of breast cancer. However, this minimally invasive technique requires facilities for frozen section (FS) and intraoperative analysis, which are sadly not available at most centers in India. At the same time Touch imprint cytology (TIC), is relatively less cumbersome technique for intraoperative assessment which may provide a fast and accurate method for intraoperative assessment of sentinel lymph nodes. Aim: This study was done to assess the accuracy and feasibility of using the TIC as an alternative to FS to assess metastasis in the sentinel node. Methods: Touch imprint cytological analysis of sentinel lymph nodes was compared prospectively with frozen section and the findings obtained on routine paraffin sections. Touch imprint slides from 32 consecutive women undergoing mastectomies (from Jan 2014 to May 2016) for invasive breast cancer (all 32 were T1-T3 and with clinically N0 nodal status) were prepared during operation from multiple sections of sentinel lymph nodes, stained with haematoxylin and eosin. Results: The sensitivity of TIC was 89.47% (95% CI, 68.49-98.81%), when compared with the final histopathological result as a gold standard method. The sensitivity of the FS was 94.74% (95% CI 73.97% to 99.87%), when compared to the HPE results. The specificity of the TIC and FS when compared to HPE is 100%. Conclusion: This study has lent credibility to the possible use of TIC as an assessment tool of the sentinel node in centers where facilities for frozen section are not available and hence expanding the population of potential beneficiaries who can be spared of morbidity associated with axillary dissection
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