Relationship between Non-Technical Factors and Diagnostic Accuracy of Frozen Section in Axillary Lymph Nodes in Patients with Breast Cancer

Regional lymph node involvement is one of the main prognostic factors for breast cancer. Intraoperative assessment of sentinel lymph node biopsy (SLNB) by frozen section (FS) allows necessary axillary lymph node dissection (ALND) at the same time. But, false negative results are the main problems of the FS. The aim of this study was to investigate the relationship between non-technical factors and occurrence of false negative FS results in SLNB.

In this retrospective cross-sectional research, we studied the medical records of patients who underwent breast cancer surgery and SLNB in 2017-2018 in Shiraz Shahid Faghihi Hospital. FS and permanent pathology (standard method for examining pathology specimens) reports were compared to determine the rate of false negatives results.

We investigated 198 patients. The average size of breast mass was26.2 mm. Sensitivity, specificity and false negative rate were 80%, 98.4%, and 19.6%, respectively. Among the non-technical factors studied, including breast tumor diameter, type of pathology, micrometastasis, tumor grade, and lymphovascular involvement, there was a significant relationship between lymphovascular involvement and false negative results (P= 0.026).

The present study showed that false-negative results were significantly higher in mass with lymphovascular invasion.