The sensitivity and specificity of sentinel lymph node biopsy for breast cancer at Baylor University Medical Center at Dallas: a retrospective review of 488 cases.

Sentinel lymph node (SLN) biopsy has become the standard of care for breast carcinoma management, as it precludes the negative morbid effects- including decreased shoulder range of motion, lymphedema, and paresthesias-of unnecessary axillary lymph node dissection. However, the method of pathologic e...

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Published in:Baylor University Medical Center Proceedings Vol. 24; no. 2; pp. 81 - 86
Main Authors: Shiller, S. Michelle, Weir, Robert, Pippen, John, Punar, Metin, Savino, Daniel
Format: pictorial research tables/charts Journal Article
Published: Taylor & Francis Ltd Apr2011
Online Access:View this record in EBSCOhost
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      dt: Apr2011
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      pub: Taylor & Francis Ltd
      place: Philadelphia, Pennsylvania
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        10.1080/08998280.2011.11928687
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        atl: The sensitivity and specificity of sentinel lymph node biopsy for breast cancer at Baylor University Medical Center at Dallas: a retrospective review of 488 cases.
      aug:
        au:
          Shiller, S. Michelle
          Weir, Robert
          Pippen, John
          Punar, Metin
          Savino, Daniel
        affil: Mayo Clinic, Rochester, Minnesota
      sug:
        subj:
          Sentinel Lymph Node Biopsy Methods
          Sensitivity and Specificity Evaluation
          Breast Neoplasms Diagnosis
          Neoplasm Metastasis Diagnosis
          Predictive Value of Tests Evaluation
          Breast Neoplasms Prognosis
          Human
          Texas
          Academic Medical Centers
          Retrospective Design
          Cytological Techniques
          Axilla
          False Negative Results
          Descriptive Statistics
          Lymph Nodes Anatomy and Histology
          Lymph Nodes Pathology
      ab: Sentinel lymph node (SLN) biopsy has become the standard of care for breast carcinoma management, as it precludes the negative morbid effects- including decreased shoulder range of motion, lymphedema, and paresthesias-of unnecessary axillary lymph node dissection. However, the method of pathologic evaluation of the lymph node has been scrutinized to obtain the greatest sensitivity, specificity, and negative predictive value, ultimately for the benefit of the patient. This retrospective study analyzed 488 biopsies completed by two surgeons and read by multiple pathologists affiliated with Pathologists Biomedical Laboratories. When metastatic disease was not grossly obvious, analysis of the SLN began with touch imprint cytology and, if necessary, a frozen section analysis. On the subsequent day, three levels of the SLN were analyzed with hematoxylin and eosin stain and immunohistochemistry with cytokeratin AE1-3 and the appropriate control. Touch imprint cytology and/or frozen section analysis (where applicable) correctly identified 78 of 89 macrometastases, with a sensitivity of 88%, specificity of 100%, and negative predictive value of 97%. Sensitivity was 72% for micrometastases and 60% for isolated tumor cells, each with 100% specificity. In conclusion, the sensitivity and specificity of SLN biopsy at our institution compares with the higher end of percentages reported in the literature.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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