Value of touch imprint cytology for intra-operative evaluation of axillary sentinel lymph node, a local experience with simple pathology facilities

Sentinel lymph node (SLN) biopsy is the procedure of choice to determine the axillary involvement in breast cancer.There are three well known methods to assess its involvement intra-operatively: Frozen section (FS), Touch imprint Cytology (TIC) and PCR assessment. FS is the commonest method used in Iranian centres. SLNB is getting widespread acceptance but FS is not available in smaller centres like Dezfool so TIC can be very useful in this remote places. MATERIAL AND METHODS: 13 consecutive patients with recently diagnosed breast cancer and no clinical evidence of lymph node involvement were included in the study. The SLN was identified in all cases with lymphoscintigraphy and blue dye technique. SLN was sent to pathology where it was bisected and cytology slides prepared with H&E staining. The average time from sending the SLN to report was 30 minutes and slides were seen by one pathologist who didn’t have previous experience with this technique. TIC was compared with permanent histo-pathological examination. RESULTS: A total of 18 SLN was identified in 13 cases, the average of 1.5 SLN per case. Mean patient age was 53 and the mean tumour size was 27 mm. In 11 cases the intraoperative and permanent results were negative. In one case the intraoperative and permanent results were positive and in on case TIC was negative but the final result was positive. There was no false positive result in this study and the false negative rate was 8% with the accuracy 92%. CONCLUSIONS:TIC is a reliable method for SN assessment during surgery. We specially recommend this method for centres where FS is not available. Our results are similar to the big university centres which show it is a simple and reliable technique which can be applied even in centres with no previous experience

کلیدواژه ها:

Breast ، Sentinel lymph node ، Touch imprint cytology