Intraoperative Touch Imprint Cytology in Breast Cancer Patients After Neoadjuvant Chemotherapy |
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| Affiliation: | 1. University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia;2. Department of Surgical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia;3. Department of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia;1. Koc University, School of Medicine, Department of Radiation Oncology, Istanbul, Turkey;2. MD Anderson Cancer Center, Department of Radiation Oncology, Houston, TX;3. Iskenderun Gelisim Hospital, Division of Radiation Oncology, Hatay, Turkey;4. Ba?kent University Faculty of Medicine, Adana Dr Turgut Noyan Research and Treatment Center, Department of Radiation Oncology, Adana, Turkey;5. Department of Radiation Oncology, Baskent University Faculty of Medicine, Ankara, Turkey;1. Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY;2. Department of Surgery, University of Rochester Medical Center, Rochester, NY;1. Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;2. Department of Ultrasound, the Second Affiliated Hospital of Harbin Medical University, Harbin, China;3. Department of Ultrasound, the Second Affiliated Hospital of Chongqing Medical University & Chongqing Key Laboratory of Ultrasound Molecular Imaging, Chongqing, China;4. Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China;5. Department of Medical Ultrasound, Fudan University Shanghai Cancer Center & Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China;6. Department of Ultrasonography, Henan Provincial People′s Hospital, Zhengzhou, China;7. Department of Ultrasound, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, China;8. Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China;9. Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China;10. Department of Ultrasound, the Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China;11. Department of Ultrasonography, First Affiliated Hospital of Guangxi Medical University, Nanning, China;12. Department of Medical Ultrasound, the Second Affiliated Hospital, School of Medicine, Xi''an Jiaotong University, Xi''an, China;13. Department of Ultrasound, Union Hospital of Fujian Medical University, Fujian Institute of Ultrasound Medicine, Fuzhou, China;14. Department of Ultrasound, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China;15. Department of Ultrasonography, Renmin Hospital of Wuhan University, Wuhan, China;16. Department of Ultrasound, Qilu Hospital, Shandong University, Jinan, China;17. Department of Ultrasound, the Third Xiangya Hospital of Central South University, Changsha, China;18. Department of Ultrasound, the Second Affiliated Hospital of Nanchang University, Nanchang, China;19. Department of Ultrasound Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;20. Department of Ultrasonography, the Affiliated Hospital of Guizhou Medical University, Guiyang, China;21. Department of Ultrasound, Shenzhen People''s Hospital, the Second Clinical Medical College of Jinan University, Shenzhen, China;22. Department of Ultrasound, the First Hospital of Shanxi Medical University, Taiyuan, China;23. Department of Ultrasound, the Second Hospital of Dalian Medical University, Dalian, China;1. Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium;2. Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL;3. Unit of Medical Oncology 2, Azienda Ospedaliera-Universitaria Pisana, Pisa, Italy;4. Laboratory for Translational Breast Cancer Research, Department of Oncology, KU Leuven, Belgium;5. Division of Hematology and Oncology, Mayo Clinic, Jacksonville, FL;6. Department of Pathology, Indiana University School of Medicine, IN;7. Department of Cancer Biology, Mayo Clinic, Jacksonville, FL;1. Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Damanhour University, Egypt;2. Department of Pharmacology and toxicology, Faculty of Pharmacy, Damanhour University, Egypt;3. Bachelor of Pharmaceutical Sciences, Faculty of Pharmacy, University of Alexandria, Alexandria, Egypt;4. Department of Clinical Oncology, Faculty of Medicine, Alexandria University, Alexandria, Egypt;1. Department of Cellular Pathology, Royal Free London Foundation Trust, London;2. Research Department of Pathology, University College London, Cancer Institute, London |
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| Abstract: | BackgroundIntraoperative touch imprint cytology (ITIC) is used for intraoperative detection of sentinel lymph node (SLN) metastases with intention to spare the patients another surgery. However, ITIC prolongs surgery, and ads costs. It is less likely positive in breast cancer (BC) patients after neoadjuvant chemotherapy (NAC) due to low axillary tumor burden. We aimed to evaluate ITIC in patients after NAC and assess how often it changes the ongoing surgery.Materials and MethodsBC patients treated with NAC followed by surgery at the Institute of Oncology Ljubljana, Slovenia, from January 2008 to July 2020 with ITIC performed were selected for analysis. Sensitivity, specificity, and the proportion of positive ITIC were calculated for different subgroups.ResultsOverall, 144 patients were identified. 73 of 144 (50.7%) patients were N0 before NAC and 71 of 144 (49.3%) were initially N1 and downstaged to N0 after NAC. ITIC was positive in 30 of 144 (20.8%) of patients, 7 of 73 (9.6%) in N0 group and 23 of 71 (32.4%) in N1 group. In N0 group, ITIC was positive in 1 of 20 (5%) if the tumor size was ≤ 20 mm after NAC, and 2 of 39 (5.1%) if the tumor was triple negative (TN) or Her-2+. In the N1 group ITIC was positive in > 20% in all subgroups. The sensitivity and specificity of ITIC was 50.8% and 100%, respectively and did not differ between groups.ConclusionITIC after NAC is accurate with comparable sensitivity to ITIC in upfront surgery. We suggest omission of ITIC after NAC in initially N0 patients, particularly for tumors ≤ 20 mm after NAC, and in TN or Her-2+ subtypes. |
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| Keywords: | Neoadjuvant chemotherapy Axillary staging Intraoperative metastases detection |
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