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Annals of Surgical Oncology 8:222-226 (2001)
© 2001 Society of Surgical Oncology

ORIGINAL ARTICLES

Frozen Section Investigation of the Sentinel Node in Malignant Melanoma and Breast Cancer

Pieter J. Tanis, MD, Rob P. A. Boom, MD, PhD, Heimen Schraffordt Koops, MD, PhD, Ian F. Faneyte, MD, Johannes L. Peterse, MD, Omgo E. Nieweg, MD, PhD, Emiel J. T. Rutgers, MD, PhD, Anton T. M. G. Tiebosch, MD, PhD and Bin B. R. Kroon, MD, PhD

From the Departments of Surgery (PJT, OEN, EJTR, BBRK) and Pathology (IFF, JLP), the Netherlands Cancer Institute, Amsterdam, the Netherlands; the Department of Surgery (RPAB), Amstelveen Hospital, Amstelveen, the Netherlands; and the Departments of Surgery (HSK) and Pathology (ATMGT), Groningen University Hospital, Groningen, the Netherlands.

Correspondence: Address correspondence and reprint requests to: P. J. Tanis, MD, Department of Surgery, the Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands; Fax: 31-20-5122554; E-mail: ptanis{at}nki.nl

Background: Intraoperative frozen section investigation allows immediate regional lymph node dissection when the sentinel node contains tumor. The purpose of this study was to determine the sensitivity of frozen section diagnosis of the sentinel node in melanoma and breast cancer patients.

Methods: A total of 177 sentinel nodes from 99 melanoma patients and 444 lymph nodes from 262 breast cancer patients were assessed by frozen section investigation. Nodes were bisected, and a complete cross-section was obtained for frozen section. Step sections at three levels were made of the remaining lymphatic tissue and were stained with hematoxylin and eosin and S100/HMB45 (melanoma) or CAM5.2 (breast cancer) to obtain a final pathological diagnosis.

Results: Frozen section investigation revealed metastases in 8 of 17 node-positive melanoma patients (47%). Seventy-one of 96 breast cancer patients (74%) with lymph node metastases were identified with frozen section. The specificity was 100% and 99%, respectively.

Conclusion: The sensitivity of intraoperative frozen section investigation of sentinel nodes was 47% in melanoma patients and 74% in breast cancer patients. Frozen section examination allows immediate axillary lymph node dissection in the majority of node-positive breast cancer patients. Frozen section analysis is not recommended in patients with melanoma.

Key Words: Frozen section • Sentinel node • Breast cancer • Melanoma




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