Our Summary

This research paper compares two methods used to evaluate axillary lymph nodes in breast cancer patients: intra-operative frozen section biopsy (FSB) and touch imprint cytology (TIC). The researchers reviewed various studies comparing these techniques to see which one is more accurate.

Their findings showed that both methods were quite effective with comparable sensitivity, specificity, and accuracy. FSB had a sensitivity of 78%, specificity of 100%, and diagnostic accuracy of 98.57%. TIC had a sensitivity of 74%, specificity of 98%, and diagnostic accuracy of 98.37%.

The conclusion is that TIC is as accurate as FSB in detecting axillary lymph node metastasis during sentinel lymph node biopsy. This means TIC could be used as a cheaper and faster alternative to FSB, making it especially useful in places with limited resources.

FAQs

  1. What are the two methods evaluated in the research for examining axillary lymph nodes in breast cancer patients?
  2. What were the sensitivity, specificity, and diagnostic accuracy of FSB and TIC as per the research findings?
  3. Can TIC be used as an alternative to FSB in detecting axillary lymph node metastasis during sentinel lymph node biopsy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sentinel lymph node biopsy is to discuss the different methods used to evaluate the lymph nodes, such as intra-operative frozen section biopsy and touch imprint cytology. It is important for the patient to understand the accuracy and effectiveness of these methods in detecting lymph node metastasis during the biopsy procedure. Patients should feel comfortable asking their healthcare provider about the specific method being used and any potential alternatives that may be available.

Suitable For

Sentinel lymph node biopsy is typically recommended for breast cancer patients who have been diagnosed with early-stage breast cancer (stage I or II) and have a tumor size less than 5 centimeters. It is also recommended for patients who have no clinical evidence of lymph node involvement, but have a high risk of lymph node metastasis based on factors such as tumor size, tumor grade, and lymphovascular invasion.

Additionally, sentinel lymph node biopsy may be recommended for patients with ductal carcinoma in situ (DCIS) who are undergoing mastectomy, as well as patients with inflammatory breast cancer.

Overall, sentinel lymph node biopsy is recommended for breast cancer patients who are at a high risk of lymph node metastasis, but do not have palpable lymph nodes on physical examination. This procedure helps determine if cancer has spread to the lymph nodes, which can impact treatment decisions and prognosis.

Timeline

Before sentinel lymph node biopsy:

  1. Patient is diagnosed with breast cancer and undergoes imaging studies to determine the extent of the disease.
  2. Patient consults with a surgeon to discuss treatment options, including the possibility of a sentinel lymph node biopsy.
  3. Patient undergoes pre-operative testing and evaluation to ensure they are a suitable candidate for the procedure.
  4. Patient may receive a marking procedure to identify the sentinel lymph node(s) prior to surgery.

After sentinel lymph node biopsy:

  1. During surgery, the surgeon injects a dye or radioactive tracer near the tumor to identify the sentinel lymph node(s).
  2. The identified sentinel lymph node(s) is removed and sent to the pathology lab for analysis using FSB or TIC.
  3. Results of the biopsy are typically available within a few days, allowing the medical team to determine if further treatment, such as lymph node dissection, is necessary.
  4. Patient may experience some discomfort and swelling at the biopsy site, which should improve with time.
  5. Patient may undergo additional treatments, such as chemotherapy or radiation therapy, based on the results of the biopsy and overall cancer staging.

What to Ask Your Doctor

  1. What is a sentinel lymph node biopsy and why is it recommended for my situation?
  2. How will the results of the biopsy impact my treatment plan?
  3. What are the risks and potential complications associated with a sentinel lymph node biopsy?
  4. How is a sentinel lymph node biopsy performed and what can I expect during the procedure?
  5. How accurate is the method being used for evaluating the lymph nodes in my case?
  6. Are there any alternative methods for evaluating the lymph nodes that could be considered?
  7. How soon will I receive the results of the biopsy?
  8. What follow-up care or monitoring will be necessary after the biopsy?
  9. How will the results of the biopsy affect my prognosis and long-term outlook?
  10. Are there any specific lifestyle changes or precautions I should take after the biopsy?

Reference

Authors: Bharath S, Sharma D, Yadav SK, Shekhar S, Jha CK. Journal: World J Surg. 2023 Feb;47(2):478-488. doi: 10.1007/s00268-022-06800-w. Epub 2022 Oct 30. PMID: 36310323