Clinical relevance of intra-operative sentinel lymph node examination in breast cancer management

To determine the sensitivity, accuracy, and clinical relevance of intra-operative examination of sentinel lymph nodes in breast cancer management. Retrospective study. Private anatomical pathology practice. Three hundred breast cancer patients who underwent axillary sentinel lymph node biopsies for intra-operative assessment between January 2004 and March 2006. Correct identification of metastatic carcinoma in sentinel lymph nodes during intra-operative examination, sparing patient a second surgery. The intra-operative diagnosis of sentinel lymph node biopsies from 300 consecutive patients were compared with the final pathological diagnoses. The final pathology results showed metastatic carcinoma in 74 patients, of whom 63 (85%) were correctly diagnosed during frozen section examination. There was no false-positive case (positive predictive value 100%). The sensitivity for detecting macro- and micro-metastases were 95% and 50%, respectively (P