PT  - JOURNAL ARTICLE
AU  - Huerta-Rosario, Mariela
AU  - Mir, Mariam
AU  - Quispe-Vicuña, Carlos
AU  - Hwang, Helena
AU  - Sarode, Venetia
AU  - Peng, Yan
AU  - Fang, Yisheng
AU  - Leitch, Marilyn
AU  - Sahoo, Sunati
TI  - Intraoperative evaluation of sentinel lymph nodes in patients with breast cancer treated with systemic neoadjuvant therapy
AID  - 10.1136/jcp-2023-208862
DP  - 2023 May 31
TA  - Journal of Clinical Pathology
PG  - jcp-2023-208862
4099  - http://jcp.bmj.com/content/early/2023/05/31/jcp-2023-208862.short
4100  - http://jcp.bmj.com/content/early/2023/05/31/jcp-2023-208862.full
AB  - Aims Touch preparation (TP) and frozen section (FS) are the two methods routinely used in the intraoperative evaluation (IOE) of sentinel lymph nodes (SLNs) to detect metastases in patients with breast cancer. Both methods are extremely sensitive and specific in the primary surgery (non-neoadjuvant systemic therapy (non-NST)) setting. Since NST introduces unique challenges in the IOE of SLNs, the aim was to determine the accuracy of TP and FS in the IOE of SLNs in the NST setting and compare the results with the non-NST setting and to examine factors that contribute to any differences.Methods We analysed 871 SLNs from 232 patients (615 SLNs from NST and 256 SLNs from non-NST settings) between 2016 through 2019.Results In the NST group, TP alone (n=366) had a sensitivity of 45.7% and specificity of 99.7%; FS alone (n=90) had a sensitivity of 83.3% and specificity of 100%. When both TP and FS (n=135) were used, the sensitivity was 80.3% and the specificity was 98.6%.In the non-NST group, TP alone (n=193) had a sensitivity of 66.7% and specificity of 100%; FS alone (n=22) had a sensitivity and specificity of 100%; and combined TP and FS (n=34) had a sensitivity and specificity of 100% and 96%, respectively.Conclusions Evaluating SLNs intraoperatively in the NST setting can be challenging secondary to therapy-related changes. In the NST setting, FS has higher sensitivity and specificity compared with TP for the IOE of SLNs and should be the preferred method.All data relevant to the study are included in the article or uploaded as supplementary information. NA.