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Breast. 2013 Oct;22(5):639-42. doi: 10.1016/j.breast.2013.07.044. Epub 2013 Aug 14.

Multiple Step-section Frozen Section sentinel lymph node biopsy--a review of 717 patients.

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The Breast Care Centre, Southmead Hospital, North Bristol NHS Trust, Southmead Road, Westbury-on-Trym, Bristol BS10 5NB, UK. Electronic address:


Sentinel Lymph Node Biopsy (SLNB) is the standard of care for axillary staging in breast cancer. Multiple Step-section Frozen Section (MSFS) analysis is used in our institution for SLNB. This is performed intra-operatively by freezing sentinel lymph nodes to obtain multiple step-sections which are examined histologically for evidence of metastases. Patients whose sentinel lymph nodes contained macrometastases proceeded to an axillary node clearance during the same operation. 717 patients over a two and a half year period had MSFS analysis. With regards to macrometastases, MSFS analysis had a sensitivity of 93.8%, a specificity of 99.3%, a positive-predictive value of 97.4% and a negative-predictive value of 98.2%. MSFS analysis of sentinel lymph nodes is a safe and accurate procedure. It is a relatively cost-effective alternative to molecular technologies relying on DNA amplification and more accurate than standard frozen section or touch-prep cytology.


ALND; Breast cancer; DCIS; Frozen section; MSFS; Multiple Step-section Frozen Section; OSNA; One Step Nucleic Acid Amplification; RT-PCR; Reverse Transcriptase Polymerase Chain Reaction; SLN; Sentinel node biopsy; WLE; axillary lymph node dissection; ductal carcinoma in-situ; sentinel lymph node; wide local excision

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