Introduction: Since the late 1970s, sentinel lymph node biopsy (SLNB) has been used for several solid malignancies to identify lymph node metastases. This procedure is associated with less surgical morbidity than complete lymphadenectomy. Recent evidence suggests that axillary lymphadenectomy is not required for breast sentinel nodes with micrometastases (≤2 mm). Current clinical management of sentinel nodes indicates that only macrometastases (#x3e;2 mm) should be detected intraoperatively. In Japan, an intraoperative histopathological frozen section (FS) method is used to identify lymph node metastases, but this method takes more than 30 min and requires complex techniques and expensive equipment. Touch imprint cytology (TIC) is an easier, less expensive, and faster method, but its sensitivity has been shown to be low. Objective: The purpose of this study was to determine if TIC is more useful than FS in identifying macrometastases in sentinel lymph nodes in preoperative node-negative breast cancer operations. Methods: A prospective review of 49 consecutive patients with node-negative breast cancer treated with SLNB and intraoperative TIC and FS between November 2017 and June 2019 was performed. TIC samples were stained using Papanicolaou and Diff-Quick stains. Results were compared with routine postoperative paraffin sections. Results: With TIC, the Papanicolaou stain took a mean of 12 min, and the Diff-Quick stain took a mean of 10 min. Results of both TIC stain methods were the same. In contrast, the FS method took a mean of 80 min (including the transfer of specimens to a different hospital with the necessary equipment). TIC confirmed macrometastases in 5 cases. All macrometastases were diagnosed equally by the 2 techniques. Both the sensitivity and specificity of TIC were 100% for detection of macrometastases. Conclusion: TIC of SLNB for breast cancer is an easy and useful method for the detection of macrometastases of breast sentinel nodes.
Acta Cytologica

中文翻译：

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乳腺癌早期患者腋前哨淋巴结术中触摸印迹细胞学和冰冻切片组织学的前瞻性比较。

简介：自1970年代末以来，前哨淋巴结活检（SLNB）已用于多种实体恶性肿瘤，以识别淋巴结转移。与完整的淋巴结清扫术相比，该过程的手术发病率更低。最近的证据表明，对于具有微小转移（≤2mm）的乳房前哨淋巴结，不需要进行腋窝淋巴结清扫术。当前的前哨淋巴结临床治疗表明，术中仅应检测到宏观转移灶（＃x3e; 2 mm）。在日本，术中使用组织病理学冰冻切片（FS）方法来识别淋巴结转移，但是这种方法需要30分钟以上，并且需要复杂的技术和昂贵的设备。触摸式印记细胞学（TIC）是一种更容易，更便宜且更快速的方法，但已证明其灵敏度较低。目的：本研究的目的是确定TIC是否比FS在确定术前淋巴结阴性乳腺癌手术前哨淋巴结中的巨转移灶方面更有用。方法：回顾性分析2017年11月至2019年6月间使用SLNB以及术中TIC和FS治疗的49例淋巴结阴性乳腺癌患者。TIC样品使用Papanicolaou和Diff-Quick染色进行染色。将结果与常规术后石蜡切片进行比较。结果：使用TIC，Papanicolaou染色平均需要12分钟，而Diff-Quick染色平均需要10分钟。两种TIC染色方法的结果均相同。相比之下，FS方法平均需要80分钟（包括将标本转移到具有必要设备的另一家医院）。TIC确诊5例。两种技术均能对所有的宏观转移均进行诊断。TIC的敏感性和特异性均为100％。结论：乳腺癌SLNB的TIC是检测乳腺癌前哨淋巴结大转移的一种简便有效的方法。
细胞学学报