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Pathology Research International
Volume 2012, Article ID 802184, 5 pages
http://dx.doi.org/10.1155/2012/802184
Research Article

Cytokeratin on Frozen Sections of Sentinel Node May Spare Breast Cancer Patients Secondary Axillary Surgery

1Department of Pathology, Herlev Hospital, 2730 Herlev, Copenhagen, Denmark
2Department of Breast Surgery, Rigshospitalet, 2100 Copenhagen, Denmark
3Department of Pathology, Rigshospitalet, 2100 Copenhagen, Denmark
4Department of Pathology, University Hospital of Copenhagen, 2100 Copenhagen, Denmark

Received 6 December 2011; Revised 11 February 2012; Accepted 25 February 2012

Academic Editor: P. J. Van Diest

Copyright © 2012 Elisabeth Specht Stovgaard et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The feasibility and accuracy of immunohistochemistry (IHC) on frozen sections, when assessing sentinel node (SN) status intraoperatively in breast cancer, is a matter of continuing discussion. In this study, we compared a center using IHC on frozen section with a center not using this method with focus on intraoperative diagnostic values. Material and Methods. Results from 336 patients from the centre using IHC intraoperatively were compared with 343 patients from the center not using IHC on frozen section. Final evaluation on paraffin sections with haematoxylin-eosin (HE) staining supplemented with cytokeratin staining was used as gold standard. Results. Significantly more SN with isolated tumor cells (ITCs) and micrometastases (MICs) were found intraoperatively when using IHC on frozen sections. There was no significant difference in the number of macrometastases (MACs) found intraoperatively. IHC increased the sensitivity, the negative predictive value, and the accuracy of the intraoperative evaluation of SN without decreasing the specificity and positive predictive value of SN evaluation. Conclusions. IHC on frozen section leads to the detection of more ITC and MIC intraoperatively. As axillary lymph node dissection (ALND) is performed routinely in some countries when ITC and MIC are found in the SN, IHC on frozen section provides valuable information that can lead to fewer secondary ALNDs.