Abstract

Background:Improvements in the process of staging and surgical treatment of axillary lymph nodes in recent years, have led to the use of intra operative frozen section pathology to examine the sentinel lymph node biopsy in breast cancer patients. Materials and Methods:we evaluated the results of the Sentinel biopsy in 102 patients with early stage breast cancer, which were negative clinical lymph nodes, and analyzing the true positive and false negative rate, diagnostic accuracy of frozen section lymph node biopsy. It also studied the factors affecting the sentinel and non-sentinel lymph nodes in patients treated by axillary lymph dissection. Results:In this study, we investigated 102 patients’ stage 1and 2 breast cancer with clinical negative axillary lymph node and candidates for sentinel lymph node biopsy, were placed under investigation. 15.7 % of the real positive results of sentinel and 62.7 % of the real negative and 2 % false positives and 20.9 % false negative results and% 78. 4 diagnostic accuracy, has been frozen section. Among the patients who were initially or delayed in the axillary dissection, 37% had more than two lymph nodes. While in general, 16.7% of patients had a need for axillary lymph node dissection based on z11 criteria. Lymph-vascular invasion was a major contributor to lentil involvement in Sentinel and non-Sentinel nodes. Conclusion:Frozen section pathology during the operation of sentinel lymph node biopsy has been initiated to prevent the need for a reoperation in early stage breast cancer patients. However, due to low tumor burden in patients who are candidates for this procedure, and the constraints in the initial sections and their false negative results, also the removal of frozen section will not have an effect on the rate of increasing reoperation and can be effective in reducing the time and cost of surgery.

Highlights

  • The Sentinel Lymph Node Biopsy technique was performed by GIULIANO in evaluating the axillary lymph nodes and is currently being used as a standard method for staging the status of the axillary lymph nodes, replacing the axillary dissection in patients with early stage breast cancer and negative clinical lymph nodes(Giuliano et al, 1994; Lyman et al, 2005)

  • Materials and Methods: we evaluated the results of the Sentinel biopsy in 102 patients with early stage breast cancer, which were negative clinical lymph nodes, and analyzing the true positive and false negative rate, diagnostic accuracy of frozen section lymph node biopsy

  • According to the results of these studies, in a study conducted by Julie et al, found that despite the effectiveness of use of intraoperative frozen section in sentinel lymph node biopsy, it tends to be used after the introduction of z11 trial, in early stage breast cancer patients who are candidates for breast conserving surgery and radiotherapy are reduced (Giuliano et al, 2011; Jorns and Kidwell, 2016)

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Summary

Introduction

The Sentinel Lymph Node Biopsy technique was performed by GIULIANO in evaluating the axillary lymph nodes and is currently being used as a standard method for staging the status of the axillary lymph nodes, replacing the axillary dissection in patients with early stage breast cancer and negative clinical lymph nodes(Giuliano et al, 1994; Lyman et al, 2005). Materials and Methods: we evaluated the results of the Sentinel biopsy in 102 patients with early stage breast cancer, which were negative clinical lymph nodes, and analyzing the true positive and false negative rate, diagnostic accuracy of frozen section lymph node biopsy. It studied the factors affecting the sentinel and non-sentinel lymph nodes in patients treated by axillary lymph dissection. Results: In this study, we investigated 102 patients’ stage 1and 2 breast cancer with clinical negative axillary lymph node and candidates for sentinel lymph node biopsy, were placed under investigation. Due to low tumor burden in patients who are candidates for this procedure, and the constraints in the initial sections and their false negative results, the removal of frozen section will not have an effect on the rate of increasing reoperation and can be effective in reducing the time and cost of surgery

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