Intraoperative Imprint Cytologic Evaluation of Sentinel Lymph Nodes for Lobular Carcinoma of the Breast
Identifieur interne : 008784 ( Main/Exploration ); précédent : 008783; suivant : 008785Intraoperative Imprint Cytologic Evaluation of Sentinel Lymph Nodes for Lobular Carcinoma of the Breast
Auteurs : Andrew J. Creager ; Kim R. Geisinger ; Nancy D. Perrier ; Perry Shen ; Jo Ann Shaw ; Peter R. Young ; Doug Case ; Edward A. LevineSource :
- Annals of Surgery [ 0003-4932 ] ; 2004.
Abstract
The evaluation of sentinel lymph nodes (SLNs) from a woman with lobular cancer of the breast is frequently challenging. Intraoperative imprint cytology (IIC) is equivalent to frozen sectioning for rapid SLN evaluation and is advantageous because it is rapid, reliable, cost-effective, and conserves tissue. Metastatic lobular carcinoma is difficult to identify in SLN because of its low-grade cytomorphology, its tendency to infiltrate lymph nodes in a single cell pattern, and because individual cells can resemble lymphocytes. We are unaware of any large published studies, using any technique, to evaluate SLN for lobular carcinoma.
A retrospective review of the intraoperative imprint cytology results of 678 SLN mapping procedures for breast carcinoma was performed. From this cohort, we studied SLN from cases of lobular carcinoma. These SLN were evaluated intraoperatively by either bisecting or slicing the SLN into 4-mm sections. Imprints were made of each cut surface and stained with hematoxylin and eosin and/or Diff-Quik. Permanent sections were evaluated with up to 4 hematoxylin and eosin-stained levels and cytokeratin immunohistochemistry. IIC results were compared with final histologic results.
Sixty-one cases of pure invasive lobular carcinoma were identified. Sensitivity was 52%, specificity was 100%, accuracy was 82%, negative predictive value was 78%. No statistically significant differences in sensitivity, specificity or accuracy were identified for the intraoperative detection of lobular carcinoma versus ductal carcinoma. The sensitivity for detecting macrometastases (more than 2 mm) was better than for detecting micrometastases, 73 versus 25%, respectively (
The sensitivity and specificity of IIC are similar to that of intraoperative frozen section evaluation. Therefore, IIC is a viable alternative to frozen sectioning when intraoperative evaluation is required. If SLN micrometastasis is used to determine the need for further lymphadenectomy, more sensitive intraoperative methods will be needed to avoid a second operation.
Url:
DOI: 10.1097/01.sla.0000103072.34708.e3
PubMed: 14685101
PubMed Central: 1356193
Affiliations:
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: 001346
- to stream Pmc, to step Curation: 001345
- to stream Pmc, to step Checkpoint: 003E36
- to stream Ncbi, to step Merge: 001780
- to stream Ncbi, to step Curation: 001780
- to stream Ncbi, to step Checkpoint: 001780
- to stream Main, to step Merge: 008A41
- to stream Main, to step Curation: 008784
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Intraoperative Imprint Cytologic Evaluation of Sentinel Lymph Nodes for Lobular Carcinoma of the Breast</title>
<author><name sortKey="Creager, Andrew J" sort="Creager, Andrew J" uniqKey="Creager A" first="Andrew J." last="Creager">Andrew J. Creager</name>
<affiliation><nlm:aff id="N0x8b48e10.0x971e7d8"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Geisinger, Kim R" sort="Geisinger, Kim R" uniqKey="Geisinger K" first="Kim R." last="Geisinger">Kim R. Geisinger</name>
<affiliation><nlm:aff id="N0x8b48e10.0x971e7d8"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Perrier, Nancy D" sort="Perrier, Nancy D" uniqKey="Perrier N" first="Nancy D." last="Perrier">Nancy D. Perrier</name>
<affiliation><nlm:aff id="N0x8b48e10.0x971e7d8"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Shen, Perry" sort="Shen, Perry" uniqKey="Shen P" first="Perry" last="Shen">Perry Shen</name>
<affiliation><nlm:aff id="N0x8b48e10.0x971e7d8"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Shaw, Jo Ann" sort="Shaw, Jo Ann" uniqKey="Shaw J" first="Jo Ann" last="Shaw">Jo Ann Shaw</name>
<affiliation><nlm:aff id="N0x8b48e10.0x971e7d8"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Young, Peter R" sort="Young, Peter R" uniqKey="Young P" first="Peter R." last="Young">Peter R. Young</name>
<affiliation><nlm:aff id="N0x8b48e10.0x971e7d8"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Case, Doug" sort="Case, Doug" uniqKey="Case D" first="Doug" last="Case">Doug Case</name>
<affiliation><nlm:aff id="N0x8b48e10.0x971e7d8"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Levine, Edward A" sort="Levine, Edward A" uniqKey="Levine E" first="Edward A." last="Levine">Edward A. Levine</name>
<affiliation><nlm:aff id="N0x8b48e10.0x971e7d8"></nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">14685101</idno>
<idno type="pmc">1356193</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1356193</idno>
<idno type="RBID">PMC:1356193</idno>
<idno type="doi">10.1097/01.sla.0000103072.34708.e3</idno>
<date when="2004">2004</date>
<idno type="wicri:Area/Pmc/Corpus">001346</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001346</idno>
<idno type="wicri:Area/Pmc/Curation">001345</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001345</idno>
<idno type="wicri:Area/Pmc/Checkpoint">003E36</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">003E36</idno>
<idno type="wicri:Area/Ncbi/Merge">001780</idno>
<idno type="wicri:Area/Ncbi/Curation">001780</idno>
<idno type="wicri:Area/Ncbi/Checkpoint">001780</idno>
<idno type="wicri:doubleKey">0003-4932:2004:Creager A:intraoperative:imprint:cytologic</idno>
<idno type="wicri:Area/Main/Merge">008A41</idno>
<idno type="wicri:Area/Main/Curation">008784</idno>
<idno type="wicri:Area/Main/Exploration">008784</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Intraoperative Imprint Cytologic Evaluation of Sentinel Lymph Nodes for Lobular Carcinoma of the Breast</title>
<author><name sortKey="Creager, Andrew J" sort="Creager, Andrew J" uniqKey="Creager A" first="Andrew J." last="Creager">Andrew J. Creager</name>
<affiliation><nlm:aff id="N0x8b48e10.0x971e7d8"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Geisinger, Kim R" sort="Geisinger, Kim R" uniqKey="Geisinger K" first="Kim R." last="Geisinger">Kim R. Geisinger</name>
<affiliation><nlm:aff id="N0x8b48e10.0x971e7d8"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Perrier, Nancy D" sort="Perrier, Nancy D" uniqKey="Perrier N" first="Nancy D." last="Perrier">Nancy D. Perrier</name>
<affiliation><nlm:aff id="N0x8b48e10.0x971e7d8"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Shen, Perry" sort="Shen, Perry" uniqKey="Shen P" first="Perry" last="Shen">Perry Shen</name>
<affiliation><nlm:aff id="N0x8b48e10.0x971e7d8"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Shaw, Jo Ann" sort="Shaw, Jo Ann" uniqKey="Shaw J" first="Jo Ann" last="Shaw">Jo Ann Shaw</name>
<affiliation><nlm:aff id="N0x8b48e10.0x971e7d8"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Young, Peter R" sort="Young, Peter R" uniqKey="Young P" first="Peter R." last="Young">Peter R. Young</name>
<affiliation><nlm:aff id="N0x8b48e10.0x971e7d8"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Case, Doug" sort="Case, Doug" uniqKey="Case D" first="Doug" last="Case">Doug Case</name>
<affiliation><nlm:aff id="N0x8b48e10.0x971e7d8"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Levine, Edward A" sort="Levine, Edward A" uniqKey="Levine E" first="Edward A." last="Levine">Edward A. Levine</name>
<affiliation><nlm:aff id="N0x8b48e10.0x971e7d8"></nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Annals of Surgery</title>
<idno type="ISSN">0003-4932</idno>
<idno type="eISSN">1528-1140</idno>
<imprint><date when="2004">2004</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Background:</title>
<p>The evaluation of sentinel lymph nodes (SLNs) from a woman with lobular cancer of the breast is frequently challenging. Intraoperative imprint cytology (IIC) is equivalent to frozen sectioning for rapid SLN evaluation and is advantageous because it is rapid, reliable, cost-effective, and conserves tissue. Metastatic lobular carcinoma is difficult to identify in SLN because of its low-grade cytomorphology, its tendency to infiltrate lymph nodes in a single cell pattern, and because individual cells can resemble lymphocytes. We are unaware of any large published studies, using any technique, to evaluate SLN for lobular carcinoma.</p>
</sec>
<sec><title>Methods:</title>
<p>A retrospective review of the intraoperative imprint cytology results of 678 SLN mapping procedures for breast carcinoma was performed. From this cohort, we studied SLN from cases of lobular carcinoma. These SLN were evaluated intraoperatively by either bisecting or slicing the SLN into 4-mm sections. Imprints were made of each cut surface and stained with hematoxylin and eosin and/or Diff-Quik. Permanent sections were evaluated with up to 4 hematoxylin and eosin-stained levels and cytokeratin immunohistochemistry. IIC results were compared with final histologic results.</p>
</sec>
<sec><title>Results:</title>
<p>Sixty-one cases of pure invasive lobular carcinoma were identified. Sensitivity was 52%, specificity was 100%, accuracy was 82%, negative predictive value was 78%. No statistically significant differences in sensitivity, specificity or accuracy were identified for the intraoperative detection of lobular carcinoma versus ductal carcinoma. The sensitivity for detecting macrometastases (more than 2 mm) was better than for detecting micrometastases, 73 versus 25%, respectively (<italic>P</italic>
= 0.059).</p>
</sec>
<sec><title>Conclusions:</title>
<p>The sensitivity and specificity of IIC are similar to that of intraoperative frozen section evaluation. Therefore, IIC is a viable alternative to frozen sectioning when intraoperative evaluation is required. If SLN micrometastasis is used to determine the need for further lymphadenectomy, more sensitive intraoperative methods will be needed to avoid a second operation.</p>
</sec>
</div>
</front>
</TEI>
<affiliations><list></list>
<tree><noCountry><name sortKey="Case, Doug" sort="Case, Doug" uniqKey="Case D" first="Doug" last="Case">Doug Case</name>
<name sortKey="Creager, Andrew J" sort="Creager, Andrew J" uniqKey="Creager A" first="Andrew J." last="Creager">Andrew J. Creager</name>
<name sortKey="Geisinger, Kim R" sort="Geisinger, Kim R" uniqKey="Geisinger K" first="Kim R." last="Geisinger">Kim R. Geisinger</name>
<name sortKey="Levine, Edward A" sort="Levine, Edward A" uniqKey="Levine E" first="Edward A." last="Levine">Edward A. Levine</name>
<name sortKey="Perrier, Nancy D" sort="Perrier, Nancy D" uniqKey="Perrier N" first="Nancy D." last="Perrier">Nancy D. Perrier</name>
<name sortKey="Shaw, Jo Ann" sort="Shaw, Jo Ann" uniqKey="Shaw J" first="Jo Ann" last="Shaw">Jo Ann Shaw</name>
<name sortKey="Shen, Perry" sort="Shen, Perry" uniqKey="Shen P" first="Perry" last="Shen">Perry Shen</name>
<name sortKey="Young, Peter R" sort="Young, Peter R" uniqKey="Young P" first="Peter R." last="Young">Peter R. Young</name>
</noCountry>
</tree>
</affiliations>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/LymphedemaV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 008784 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 008784 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Wicri/Sante |area= LymphedemaV1 |flux= Main |étape= Exploration |type= RBID |clé= PMC:1356193 |texte= Intraoperative Imprint Cytologic Evaluation of Sentinel Lymph Nodes for Lobular Carcinoma of the Breast }}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:14685101" \ | HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \ | NlmPubMed2Wicri -a LymphedemaV1
This area was generated with Dilib version V0.6.31. |