Abstract

ROLE OF INTRAOPERATIVE IMPRINT CYTOLOGY FOR DIAGNOSIS OF SENTINEL NODE METASTASIS IN BREAST CANCER- A TWO YEAR PROSPECTIVE STUDY IN A TERTIARY CARE CENTRE

Author(s): Madhusmita Nayak, Sunanda Nayak, Kailash Chandra Agrawal

BACKGROUND Sentinel node imprint cytology has emerged as a standard diagnostic modality for breast cancer. It represents a reliable predictor of axillary lymph node status in cancer patients. This study was undertaken to assess the diagnostic accuracy of imprint cytology as an intraoperative tool for evaluating sentinel node in clinically node negative breast cancer patients. METHODS This study was conducted in the Department of Pathology, VIMSAR, Burla from November 2016 to September 2018. Out of 60 newly diagnosed invasive mammary carcinoma cases, sentinel lymph node was identified intraoperatively in 52 cases by mapping with methylene blue and gentian violet. Subsequently, study was done by staining the imprinted slides of sectioned lymph node with Diff-Quick and Papanicolaou stain, later correlated with permanent histopathology study. RESULTS Out of a total of 52 patients, SLN metastasis was seen in 12 cases in intraoperative cytology but in permanent histopathology sections 20 were positive for metastasis. Methylene blue was 93-95% sensitive and 100% specific in detecting the sentinel node. Also, gentian violet which is not routinely used as a mapping dye, showed 95% sensitivity and 99% specificity. CONCLUSIONS This study demonstrates the accuracy of mapping and identification of sentinel lymph node by the blue dyes during surgery. It determines the therapeutic significance of rarely node positive case for metastasis which were clinically node negative.