Cytologic diagnosis of axillary lymph node metastasis in breast cancer

Acta Cytol. 2000 Jan-Feb;44(1):18-22. doi: 10.1159/000326219.

Abstract

Objective: To compare imprint cytology with histology as a method for rapid intraoperative diagnosis of axillary lymph node metastasis in breast cancer.

Study design: We evaluated imprint cytology, comparing it with histopathology. A sample of 635 axillary lymph nodes was studied by imprint cytology using both Giemsa stain and hematoxylin-eosin. The results were compared with each other and with those of histopathologic examination.

Results: The Giemsa stain method, as compared to histopathology, had 94% accuracy, 97% sensitivity, 90% specificity and 94% positive prognostic value. The hematoxylin-eosin stain method was less accurate than the Giemsa stain method as compared to histopathology (accuracy 91%, sensitivity 96%, specificity 83% and positive prognostic value 92%).

Conclusion: These data confirm the value of imprint cytology as a rapid, reliable method of intraoperative assessment of axillary lymph node metastasis in breast cancer. It results in better staging of the disease. It can be used intraoperatively, as an alternative to frozen section, if a pathology laboratory is not available, to exclude stage I patients from further treatment.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / secondary
  • Adult
  • Aged
  • Aged, 80 and over
  • Axilla
  • Breast Neoplasms / diagnosis*
  • Cytodiagnosis
  • Female
  • Humans
  • Intraoperative Period
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Staging
  • Predictive Value of Tests
  • Reproducibility of Results