Intraoperative assessment of sentinel lymph nodes in breast cancer

Background: Sentinel lymph node biopsy (SLNB) reduces the morbidity of axillary clearance and is the standard of care for patients with clinically node‐negative breast cancer. The ability to analyse the sentinel node during surgery enables a decision to be made whether to proceed to full axillary cl...

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Bibliographic Details
Published in:British journal of surgery 2011-01, Vol.98 (1), p.4-17
Main Authors: Layfield, D. M., Agrawal, A., Roche, H., Cutress, R. I.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Breast Neoplasms - pathology
Breast Neoplasms - therapy
Female
Forecasting
Frozen Sections - methods
General aspects
Gynecology. Andrology. Obstetrics
Humans
Intraoperative Care - methods
Lymphatic Metastasis
Mammary gland diseases
Medical sciences
Nucleic Acid Amplification Techniques
Reverse Transcriptase Polymerase Chain Reaction - methods
Sentinel Lymph Node Biopsy - methods
Tumors
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Summary:Background: Sentinel lymph node biopsy (SLNB) reduces the morbidity of axillary clearance and is the standard of care for patients with clinically node‐negative breast cancer. The ability to analyse the sentinel node during surgery enables a decision to be made whether to proceed to full axillary clearance during primary surgery, thus avoiding a second procedure in node‐positive patients. Methods: Current evidence for intraoperative sentinel node analysis following SLNB in breast cancer was reviewed and evaluated, based on articles obtained from a MEDLINE search using the terms ‘sentinel node’, ‘intra‐operative’ and ‘breast cancer’. Results and conclusion: Current methods for evaluating the sentinel node during surgery include cytological and histological techniques. Newer quantitative molecular assays have been the subject of much recent clinical research. Pathological techniques of intraoperative SLNB analysis such as touch imprint cytology and frozen section have a high specificity, but a lower and more variably reported sensitivity. Molecular techniques are potentially able to sample a greater proportion of the sentinel node, and could have higher sensitivity. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. An expanding technique
ISSN:0007-1323
1365-2168
DOI:10.1002/bjs.7229