Metastatic breast carcinoma in the sentinel lymph node: an evaluation and comparison of cytological with histopathological diagnosis

To evaluate the accuracy of imprint cytology in identifying metastases in the sentinel lymph node and comparing it with histopathology of the same nodes. Sentinel lymph node was identified in 80 cases of early (T1 and T2) breast carcinoma by a localization technique, using 1% Isosulphan Blue. Cytological evaluation of the touch imprints were compared with subsequent histopathology. Cytology of the lymph node, as compared to the histopathology, had 86.79% sensitivity (SE) and 100% specificity (SP). The Positive Predictive Value (PPV) was 100% and the Negative Predictive Value (NPV) was 79.41%. The accuracy was 91.2%. Current study confirms the value of imprint cytology as a rapid and reliable method of assessment of sentinel lymph node metastases in breast carcinoma. It can be used intra-operatively as an alternative to frozen section, if a Cryostat is not available in the pathology laboratory to exclude Stage I patients from extensive surgery. (author)