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Intraoperative imprint cytology versus histological diagnosis for the detection of sentinel lymph nodes in breast cancer treated with neoadjuvant chemotherapy
Delgado-Bocanegra, Ronald Enrique; Millen, Eduardo Camargo; Nascimento, Cristina Moreira do; Bruno, Karine de Aguiar.
  • Delgado-Bocanegra, Ronald Enrique; Instituto Nacional do Cancer. Rio de Janeiro. BR
  • Millen, Eduardo Camargo; Instituto Nacional do Cancer. Rio de Janeiro. BR
  • Nascimento, Cristina Moreira do; Instituto Nacional do Cancer. Rio de Janeiro. BR
  • Bruno, Karine de Aguiar; Instituto Nacional do Cancer. Rio de Janeiro. BR
Clinics ; 73: e363, 2018. tab
Article in English | LILACS | ID: biblio-952807
ABSTRACT

OBJECTIVES:

To compare imprint cytology and paraffin section histology for sentinel lymph node detection in women with breast cancer treated with neoadjuvant chemotherapy.

METHOD:

A cross-sectional study and report of the sentinel lymph node statuses of 64 patients with breast cancer who underwent intraoperative imprint cytology and neoadjuvant chemotherapy in a referral cancer institute in Rio de Janeiro, Brazil, between 2014 and 2016.

RESULTS:

The mean age was 51 years. The most common histological type was invasive ductal carcinoma (93.75%), and the most common differentiation grade was 2 (62.5%). Overall, 153 lymph nodes were identified, with a mean of 2.39/case. Thirty-four lymph nodes tested positive for malignancy by imprint cytology, and 55 tested positive by histology. Of the 55 positive lymph nodes, 41 (74.5%) involved macrometastases, and 14 (25.5%) involved micrometastases. There were 21 false negatives with imprint cytology, namely, 7 for macrometastases and 14 for micrometastases, resulting in a rate of 17.6%. The sensitivity of imprint cytology was 61.8%, with a specificity and positive predictive value of 100%, a negative predictive value of 82.4% and an accuracy of 86.3%. The method presented null sensitivity for the identification of micrometastases.

CONCLUSIONS:

The false-negative rate with imprint cytology was associated with the number of sentinel lymph nodes obtained. The rate found for complete response to neoadjuvant chemotherapy was comparable to the rates reported in the literature. The accuracy of imprint cytology was good, and its specificity was excellent for sentinel lymph node detection; however, the method was unable to detect lymph node micrometastases.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Breast Neoplasms / Carcinoma, Ductal, Breast / Neoadjuvant Therapy / Sentinel Lymph Node Biopsy / Sentinel Lymph Node Type of study: Diagnostic study / Observational study / Prevalence study / Prognostic study / Risk factors Limits: Adult / Aged / Aged80 / Female / Humans Language: English Journal: Clinics Journal subject: Medicine Year: 2018 Type: Article Affiliation country: Brazil Institution/Affiliation country: Instituto Nacional do Cancer/BR

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Full text: Available Index: LILACS (Americas) Main subject: Breast Neoplasms / Carcinoma, Ductal, Breast / Neoadjuvant Therapy / Sentinel Lymph Node Biopsy / Sentinel Lymph Node Type of study: Diagnostic study / Observational study / Prevalence study / Prognostic study / Risk factors Limits: Adult / Aged / Aged80 / Female / Humans Language: English Journal: Clinics Journal subject: Medicine Year: 2018 Type: Article Affiliation country: Brazil Institution/Affiliation country: Instituto Nacional do Cancer/BR