Lymph Node Metastasis in Patients with Frozen Section Analyses That Are Negative for Tumors

作者：Lee Se Kyung; Lee Kyo Won; Kim Sangmin; Choi Min Young; Kim Jiyoung; Lee Jeonghui; Jung Seung Pil; Choe Jun Ho; Kim Jung Han; Kim Jee Soo; Lee Jeong Eon; Yang Jung Hyun; Nam Seok Jin^*

来源：Oncology, 2012, 83(1): 31-37.

DOI：10.1159/000336486

• Breast neoplasm
• Frozen section analysis
• Lymph node metastasis
• Sentinel lymph node biopsy
• Axillary lymph node dissection

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.

• 出版日期2012