Home > Journals > Il Giornale Italiano di Radiologia Medica > Past Issues > Il Giornale Italiano di Radiologia Medica 2018 Gennaio-Febbraio;(5)1 > Il Giornale Italiano di Radiologia Medica 2018 Gennaio-Febbraio;5(1):94-100



Publication history
Cite this article as


Official Journal of the Italian Society of Medical Radiology (SIRM)




Il Giornale Italiano di Radiologia Medica 2018 Gennaio-Febbraio;5(1):94-100

DOI: 10.23736/S2283-8376.17.00009-2


language: Italian

Is it possible to reduce the number of intraoperative histological examinations of the sentinel node in breast cancer?

Ildebrando D'ANGELO 1, Giancarlo POMPEI 2, Cinzia LABRUZZO 3, Francesca IGNATTI 2, Roberta RUSIGNUOLO 4, Rosalia TINAGLIA 1, Giovanna ROMANO 1, Massimo MIDIRI 4

1 Unità di Radiologia, Fondazione G. Giglio di Cefalù, Cefalù, Palermo, Italia; 2 Unità di Anatomia Patologica, Fondazione G. Giglio di Cefalù, Cefalù, Palermo, Italia; 3 Unità di Chirurgia, Fondazione G. Giglio di Cefalù, Cefalù, Palermo, Italia; 4 Istituto di Radiodiagnostica, Università degli Studi di Palermo, Palermo, Italia


BACKGROUND: Sentinel node biopsy (SLNB) is able to detect a metastatic node involvement in patients with breast cancer and clinically negative axilla. The histological examination of sentinel node (SLN) can be simultaneously carried out on breast surgery (“extemporaneous” intraoperative histological examination), or deferred (“definitive histological examination”): different timing of performance examination brings with it important differences regarding both time, costs of operating theatre and “patient compliance.” The aim of the study is to identify biological and histological parameters able to provide a different stratification of metastasis risk in sentinel node, in order to identify cases for definitive histological examination.
METHODS: Were retrospectively evaluated 120 patients, with breast cancer and clinically negative axilla, submitted every year (from 2010 to 2014) to SLNB with extemporaneous intraoperative histological examination. Diagnosis was achieved preoperatively by main lesion core biopsy for all these patients, determining for each of them, histology, main lesion size (T), grading, receptor status, proliferation index (Ki 67), HER2neu expression state. They also have been further differentiated according to the number of lesions (unifocality vs. multifocality and/or multicentricity) and age.
RESULTS: Stratification (according to different biological and histological considered parameters) has allowed the identification of two classes of patients with a different risk of probable positivity to SLN histological examination. Seventy-nine cases are included in a class with a low positive probability to SLN histological examination, with a percentage of 13.9% of false negative cases: in this class were the G1 cases, G2 with Ki 67 less than or equal to 30, the G3 cases with Ki 67 less than or equal to 20. G2 cases with Ki 67 >30, the G3 with Ki 67 >20, all negative cases ER and PgR, and multifocal/multicentric, belong to the second class, with a probable SLN presence of node metastases equal approximately 50% (20/41). These two classes of risk are not depending on variables related to age, mammary tumor lesion size, and HER2/neu expression status.
CONCLUSIONS: Application of these criteria would avoid extemporaneous intraoperative examination of 2/3 sentinel node cases with a significant reduction in surgical time and costs compared to a low percentage of reoperations (14%).

KEY WORDS: Sentinel lymph node biopsy - Histological techniques - Axilla - Dissection

top of page

Publication History

Issue published online: February 27, 2018
Manoscritto accettato: 11 dicembre 2017
Manoscritto ricevuto: 1 dicembre 2017

Cite this article as

D’Angelo I, Pompei G, Labruzzo C, Ignatti F, Rusignuolo R, Tinaglia R, et al. È possibile ridurre il numero di esami istologici intraoperatori del linfonodo sentinella nel carcinoma della mammella? G Ital Radiol Med 2018;1:94-100. DOI: 10.23736/S2283-8376.17.00009-2

Corresponding author e-mail