Should We Perform the Intraoperative Sentinel Lymph Node Biopsy in Breast Cancer?
INTRODUCTION
The purpose of this study was to evaluate the utility of performing a selective intraoperative sentinel lymph node biopsy (SLNB) in breast cancer patients.


PATIENTS AND METHODS
Patients in this prospective study were women with breast cancer seen at our hospital in 2014. These patients were divided into 2 groups on the basis of the clinical criteria age, tumor size, and molecular subtype: (1) Group A: women with clinical criteria indicative of the need to perform an intraoperative analysis of the sentinel lymph node (SLN); and (2) Group B: women in whom postoperative analysis of the SLN was performed. The final anatomopathologic findings obtained for the SLNs were analyzed and the sensitivity, specificity, positive predictive value, and negative predictive value of the clinical criteria used to decide between intraoperative or postoperative analysis of the SLN were estimated.


RESULTS
A total of 170 patients were included: 106 in group A and 64 in group B. The number of positive SLNs was 29 (22 in group A and 7 in group B; P = .09). The sensitivity of our clinical criteria for establishing the indication to perform an axillary SLNB was 75.86% (95% confidence interval [CI], 56.05%-88.98%), the specificity was 40.43% (95% CI, 32.35%-49.03%), the positive predictive value was 20.75% (95% CI, 13.73%-29.95%), and the negative predictive value was 89.06% (95% CI, 78.16%-95.12%).


CONCLUSIONS
The clinical findings used to decide whether or not to perform an SLNB exhibit low sensitivity and specificity and must therefore not be used to decide the need for an intraoperative SLNB.
['Ceberio|Nagore|N|', 'Cuadra|María|M|', 'Mendizabal|José Luis|JL|', 'Gorostiaga|Javier|J|', 'Lete|Iñaki|I|']
D000367:Age Factors D001365:Axilla D001943:Breast Neoplasms D000066491:Clinical Decision-Making D005260:Female D006801:Humans D007430:Intraoperative Care D008207:Lymphatic Metastasis D008408:Mastectomy D008875:Middle Aged D009367:Neoplasm Staging D011182:Postoperative Care D017410:Practice Guidelines as Topic D011237:Predictive Value of Tests D011446:Prospective Studies D012680:Sensitivity and Specificity D000071036:Sentinel Lymph Node D021701:Sentinel Lymph Node Biopsy
Sensitivity Specificity Intraoperative breast cancer Selective sentinel lymph node biopsy