METASTATIC BREAST CARCINOMA IN THE SENTINEL LYMPH NODE: AN EVALUATION AND COMPARISON OF CYTOLOGICAL WITH HISTOPATHOLOGICAL DIAGNOSIS

Objective: To evaluate the accuracy of imprint cytology in identifying metastases in the sentinel lymph node and comparing it with histopathology of the same nodes. Study Design: Cross- sectional. Place and Duration of Study: Departments of Pathology, Punjab Medical College, Faisalabad and Sheikh Zayed Hospital, Lahore and Departments of Surgery, Allied and DHQ Hospitals, Faisalabad, between July 2002 June 2003. Patients and Methods: Sentinel lymph node was identified in 80 cases of early (T1 and T2) breast carcinoma by a localization technique, using 1% Isosulphan Blue. Cytological evaluation of the touch imprints were compared with subsequent histopathology. Results: Cytology of the lymph node, as compared to the histopathology, had 86.79% sensitivity (SE) and 100% specificity (SP). The Positive Predictive Value (PPV) was 100% and the Negative Predictive Value (NPV) was 79.41%. The accuracy was 91.2%. Conclusion: Current study confirms the value of imprint cytology as a rapid and reliable method of assessment of sentinel lymph node metastases in breast carcinoma. It can be used intra-operatively as an alternative to frozen section, if a Cryostat is not available in the pathology laboratory to exclude Stage I patients from extensive surgery.