Can we use frozen section analysis of sentinel lymph nodes mapped with methylene blue dye for decision making upon one-time axillary dissection in breast carcinoma surgery in developing countries?

e12037Background: The aim was to evaluate accuracy of intraoperative frozen section analysis (FSA) of sentinel lymph nodes (SLN) mapped using methylene blue dye (MBD) and its usefulness for selecting patients with breast carcinomas and positive axillary lymph nodes (ALN) for one-time axillary dissection. Methods: Following 2005 ASCO guidelines, 152 female patients with T1/T2 breast carcinomas and clinically negative ALNs were selected for mapping using MBD (1%) from October 2010 to December 2011. Patients underwent FSA of mapped SLNs and ALN dissection. The accuracy of SLN-FSA was tested by comparison of these findings with definite pathohistology on SLNs, as well as on other ALNs. Sensitivity, specificity, positive and negative predictive values were calculated. Results: There was a 98%-match between FSA and definite pathohistology findings on SLNs, which suggests the high accuracy of FSA in this series. None of 3 patients with false-negative SLNs on FSA had additional axillary metastases. One out of 20 ...