False-negative Frozen Section of Sentinel Lymph Node Biopsy in a Chinese Population with Breast Cancer

Abstract

Aim: This study aimed to investigate the accuracy of frozen section (FS) in diagnosis of sentinel lymph node metastasis and to analyze the predictive factors for false-negativity.

Patients and methods: Patients with breast cancer and clinically negative axillary were recruited for sentinel lymph node biopsy (SLNB). All nodes were examined by intraoperative FS and underwent further paraffin sectioning.

Results: A total of 1,272 patients underwent SLNB over an 8-year period, and 53 patients had false-negative FS. Univariate and multivariate analysis revealed that younger age, stellate mammographic pattern, and ER-positive status were statistically different when compared to the 53 members of the cohort who were truly negative on SLNB (control group). Eight patients were lost to clinical follow-up; the recurrence-free survival rate of the remaining 49 patients with false-negative SLNB did not differ from that of the 49-patient cohort (control group) (p=0.072), while these patients did experience poorer overall survival (p=0.035).

Conclusion: Younger age, stellate mammographic pattern and ER-positive status were independent predictors for false-negative FS on biopsy.

Keywords: Breast neoplasms; false-negative reaction; frozen section; predictive value of tests; sentinel lymph node biopsy.