Lymph Node Metastasis in Patients with Frozen Section Analyses That Are Negative for TumorsLee S.K. · Lee K.W. · Kim S. · Choi M.-Y. · Kim J. · Lee J. · Jung S.P. · Choe J.-H. · Kim J.-H. · Kim J.S. · Lee J.E. · Yang J.-H. · Nam S.J.
aDivision of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, and bDepartment of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
Objectives: This study was designed to assess the necessity of delayed complete axillary lymph node dissection (cALND) for patients whose sentinel lymph nodes (SLNs) were negative for tumors on intraoperative frozen section analysis, but later proven positive on hematoxylin and eosin staining or immunohistochemistry. Methods: We identified 341 patients who underwent sentinel lymph node biopsy (SLNB) with cALND at the Samsung Medical Center between 1998 and 2008, and reviewed the clinicopathological records of women diagnosed with invasive carcinoma of the breast. Results: Of the 341 patients, 59 underwent delayed cALND due to negative results on frozen section. Only 1 patient had a non-SLNs metastasis in the group of delayed cALND. Delayed cALND was associated with higher rates of breast-conserving surgery, smaller primary tumor and metastasis size in SLNs, fewer metastatic lymph nodes and SLNs and a lower TNM stage. The detection of metastases of SLNs on frozen section and the number of metastatic SLNs were related to the detection of additional metastases of nonsentinel lymph nodes (NSLNs) in cALND. Conclusion: Our findings suggest that the lack of detection of metastases on frozen sections may be a predictive factor for nonmetastasis in NSLNs. cALND could therefore be omitted in such cases.
Seok Jin Nam, MD, PhD
Division of Breast and Endocrine Surgery, Department of Surgery
Samsung Medical Center, Sungkyunkwan University School of Medicine
50 Irwon-dong, Gangnam-gu, Seoul 135-710 (Korea)
Tel. +82 234 103 478, E-Mail firstname.lastname@example.org
S.K.L. and K.W.L. contributed equally to this work.
Received: October 19, 2011
Accepted after revision: January 3, 2012
Published online: June 21, 2012
Number of Print Pages : 7
Number of Figures : 1, Number of Tables : 3, Number of References : 24
Oncology (International Journal for Cancer Research and Treatment)
Vol. 83, No. 1, Year 2012 (Cover Date: July 2012)
Journal Editor: Markman M. (Philadelphia, Pa.)
ISSN: 0030-2414 (Print), eISSN: 1423-0232 (Online)
For additional information: http://www.karger.com/OCL