Touch imprint cytology of the sentinel lymph nodes might not be indicated in early breast cancer patients with ultrasonically uninvolved axillary lymph nodes

Background: Touch imprint cytology (TIC) is a fast, cheap and specific intraoperative examination of the sentinel lymph nodes (SLNs) in early breast cancer patients. The results of TIC in patients with ultrasonically (US) uninvolved axillary lymph nodes are not known. The objective of our study was to compare the results of TIC in the patients with US uninvolved axillary lymph nodes (US group) and those with only clinically uninvolved axillary lymph nodes (non-US group). Methods: A total of 470 patients were included in the study, 257 in the US group and 213 in the non-US group. TIC results were compared to the definite histology, and the sensitivity of TIC was calculated for both groups of patients. A subgroup analysis of TIC findings with regard to the primary tumor size was performed. Results: Overall sensitivity and sensitivity for detecting macrometastases was significantly lower in the US group compared with the non-US group. In the US group, TIC results changed the course of treatment in 9% of patients, while in the non-US group, the course of treatment was changed in 22% of patients. In the non-US group, the proportion of positive TIC results increased with increasing tumor size, whereas in the US group it did not. Conclusion: The sensitivity of TIC is lower in the patients with US uninvolved axillary lymph nodes compared to those with only clinically uninvolved axillary lymph nodes. TIC might not be indicated in patients with US uninvolved axillary lymph nodes as it changes the course of treatment in only 9% of patients.