Intraoperative sentinel node biopsy, is it worth the wait?

Area of Science:

• Oncology
• Surgical Pathology

Background:

• Intraoperative analysis of selective sentinel lymph node biopsy (SLNB) is standard practice.
• The benefit of deferring SLNB results is not well-established.

Purpose of the Study:

• To determine the proportion of patients who benefit from awaiting SLNB results.
• To evaluate the impact of deferred SLNB results on surgical management.

Main Methods:

• Retrospective analysis of 149 women with T1-T2 tumors undergoing lumpectomy and SLNB.
• SLNB analysis was performed using the One-Step Nucleic Acid Amplification (OSNA) method.
• Comparison between patients treated with axillary lymph node dissection (ALND) and those treated with SLNB alone.

Main Results:

• No significant demographic differences between ALND and SLNB-only groups.
• 18 axillary lymphadenectomies were performed, with 3 or more sentinel nodes found in only 6 cases.
• Tumor location, lymphovascular permeation, and total tumor load (TTL) were significant factors; TTL was the independent predictor for ALND.

Conclusions:

• Deferred SLNB results can decrease anesthesia time and operating room occupancy.
• A significant percentage of patients avoid unnecessary additional procedures by awaiting SLNB results.