Intérêt de l’examen extemporané du ganglion sentinelle dans le cancer du sein. Étude rétrospective sur 293 patientes

Conclusion L’examen extemporané du GS apporte un bénéfice limité dans la prise en charge thérapeutique des patientes du fait du fort taux de faux-négatifs. La diffusion de l’échographie axillaire préopératoire pourrait diminuer la sensibilité de l’examen extemporané et remettre en question son intérêt. Objectives Intraoperative positive frozen section of sentinel axillary lymph node in breast cancer allows the full node dissection at the same time of the breast surgery and the enhancement of adjuvant therapies with no delay. The low frequency of node involvement and the high rate of false-negative, make consider the value of intraoperative frozen section. The aim of this study was to analyze the potential advantage of intraoperative frozen section performed routinely. Methods Retrospective monocentric study of 293 patients, operated on for stage pT1 or pT2 breast cancer with a sentinel node biopsy (SNB). Results A total of 289 patients had an intraoperative frozen section of the SNB. A sentinel node was identified in 98.6% of the cases. On intraoperative section, sentinel node was negative, positive or was not performed in 252 (86%), 37 (12.6%) and 4 (1.4%) cases respectively. In total, ibtraoperative frozen sections identified 48.7% of the metastatic SNB (37/76). The metastatic lymph node distribution, after final histological analysis, was as follows: 17% macro metastasis, 5.8% micro metastasis and 3% isolated tumor cells. The false-negatives rate...
Source: Gynecologie Obstetrique and Fertilite - Category: OBGYN Source Type: research