A Study on Sentinel Node and Occult Lesion Localisation: Do We Really Need an Intraoperative Frozen Examination?
Journal Title: Istanbul Medical Journal - Year 2020, Vol 21, Issue 4
Abstract
Introduction: The sentinel node and occult lesion localisation (SNOLL) technique combines radio-guided occult lesion localisation and sentinel lymph node biopsy (SLNB) using radioisotopes. In addition to the success of the SNOLL procedure, we investigated the efficacy and necessity of intraoperative frozen pathology in terms of clear margins and reinterventions in non-palpable breast lesions (NPBLs). Methods: The study was conducted at a single centre, in a general surgery clinic between 2006-2016. The medical records of 83 patients with NPBLs and negative axillae were acquired. Before surgery, patients were administered peritumoral and subdermal radionuclide tracer at the axillary region. All the patients underwent breast-conserving surgery and SLNB using a gamma probe following SNOLL. Results: A malignancy was detected in 78 of 83 lesions. Analyses of intraoperative frozen sections showed that the surgical margins were clear in 35 (44.9%), close in 17 (21.7%), and involved in 26 (33.3%) patients. Patients in the latter two groups underwent intraoperative re-excision of the tumour. On the final paraffin sections, surgical margin positivity was determined in seven (9%) patients. Sentinel lymph nodes (SLNs) were detected successfully in 77 of 78 patients (98.7%). The overall success rate of the SNOLL procedure was 88.5% (69/78) in patients surgically treated in a single operation. Intraoperative re-excision was beneficial in only 3 of 78 (3.8%) patients. Conclusion: SNOLL is a feasible, simple, and time-saving method for localising non-palpable breast cancers and SLNs. However, the contribution of margin assessment using frozen sections to the success of the method is limited.
Authors and Affiliations
Kivilcim Ulusan, Melis Baykara Ulusan, Mehmet Velidedeoğlu, Tülin Öztürk, Onur Erdem Şahin, Sina Ferahman, Mehmet Ferahman
Keywords
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- DOI 10.4274/imj.galenos.2020.60430
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