Abstract
Objective: We clarifited the usefulness of intraoperative imprint cytology combined with immunocytochemistry (ICC) in detecting cancer cells metastasizing to sentinel lymph nodes (SLNs) in patients with breast cancer.
Study Design: We analyzed 134 patients who underwent surgical resection for breast cancer. SLNs obtained from patients during surgery were sectioned at 2 mm intervals and imprinted onto glass slides, followed by Papanicolaou and immunocytochemical staining using anticytokeratin antibody.
Results: Permanent sections combined with immunohistochemical analysis using anticytokeratin antibody demonstrated cancer metastasis to SLNs in 37 patients. The sensitivity of imprint cytology was 78.4%, imprint cytology combined with ICC 89.2%, and frozen section 75.7%. Specificity of frozen section evaluated as 100% became 96.9% for the other two methods. Accuracy for imprint cytology was 91.7%, imprint cytology combined with ICC 94.8%, and frozen section and 93.3%. Four false negative and false positive cases evaluated by imprint cytology combined with ICC were present. False negatives and probably false positives were generated by micrometastasis.
Conclusion: Sensitivity is significant improved when ICC is added. Imprint cytology combined with ICC is useful for intraoperatively evaluating metastasis to SLNs in patients with breast cancer.
