Patients whose SLN have no or limited involvement (isolated tumor cells or micrometastases or macrometastases without extra-capsular extension) can omit ALND safely. Sentinel lymph node biopsy (SLNB) is a minimally invasive technique for assessing the axilla it had been used as an alternative to axillary lymph node dissection (ALND) and has become care management for clinically node-negative cancer patients as it is significantly reduced surgical morbidity. Some studies have used ultrasound (US) examination alone others have used fine-needle aspiration cytology (FNAC) with or without ultrasound guidance. There are several pre-operative methods to detect metastases in the axillary lymph node. Intraoperative US is a good negative test in the assessment of ex vivo SLNB, but it is not a good positive test, so it cannot replace the intraoperative frozen section in the assessment of SLNs.Īxillary lymph node (LN) metastasis is an important factor in the prognosis of breast cancer because of their impact on further patient management and overall survival. The sensitivity, specificity, PPV, NPV, and accuracy of US in the detection of positive lymph nodes were 95.45%, 82%, 70%, 97.62%, and 86.11%, respectively, and the sensitivity, specificity, PPV, NPV, and accuracy of frozen examination in the detection of positive lymph nodes were 90.91%, 96%, 90.91%, 96%, and 94.44%, respectively. The number of positive nodes by the US, frozen, and paraffin section examinations was 41.70%, 30.60%, and 30.60% respectively. The number of negative nodes by US, frozen, and paraffin section examination was 58.30%, 69.40%, and 69.40%, respectively. All the results were correlated with the final histopathological results. All excised lymph nodes were examined by the intraoperative US and frozen section examinations. The study is a prospective study that included 216 female patients with early breast cancer and negative axillary lymph nodes. This study evaluates the capability of using an ultrasound (US) as an alternative tool for the frozen section in the assessment of the ex vivo sentinel lymph node biopsy in countries with limited resources. Sentinel lymph node biopsy (SLNB), which was first investigated in the early 1990s, has replaced routine axillary lymph node dissection. Surgical management of the axilla has evolved greatly in the last 20 years. Accurate staging and proper management of axillary lymph nodes (ALNs) in breast cancer patients are important for treatment.
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