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Intraoperative Pathological Examination of Breast Lesions

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Breast Disease

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Abstract

This chapter describes the intraoperative pathological examination of breast lesions and the pathological examination of sentinel lymph nodes in breast cancer cases. Intraoperative pathological examination may be performed for the rapid diagnosis of breast malignancy, the assessment of the surgical margins of breast-conserving excision specimens, and the pathological analysis of sentinel lymph nodes. The most commonly used methods for intraoperative pathological examination of breast lesions are cytological and frozen-section examinations in addition to gross analysis. The pathological examinations of sentinel lymph nodes necessitate careful gross examination and serial and/or step sectioning. Immunostaining using antibodies against pancytokeratin can also be performed. Sentinel lymph node metastases should be clearly defined as macro- or micrometastasis or isolated tumor cells. The differential diagnosis of subtypes of metastasis and mimickers is detailed.

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References

  1. Rosen PP, Senie R, Schottenfeld D, Ashikari R. Noninvasive breast carcinoma: frequency of unsuspected invasion and implication for treatment. Ann Surg. 1979;89:98–103.

    Google Scholar 

  2. Speights VO Jr. Evaluation of frozen sections in grossly benign breast biopsies. Mod Pathol. 1994;7:762–5.

    PubMed  Google Scholar 

  3. Niemann TH, Lucas JG, Marsh WL Jr. To freeze or not to freeze. A comparison of methods for the handling of breast biopsies with no palpable abnormality. Am J Clin Pathol. 1996;106:225–8.

    Article  CAS  PubMed  Google Scholar 

  4. Bianchi S, Palli D, Ciatto S, Galli M, Giorgi D, Vezzosi V, et al. Accuracy and reliability of frozen section diagnosis in a series of 672 nonpalpable breast lesions. Am J Clin Pathol. 1995;103:199–205.

    Article  CAS  PubMed  Google Scholar 

  5. Ferreiro JA, Gisvold JJ, Bostwick DG. Accuracy of frozen-section diagnosis of mammographically directed breast biopsies. Results of 1,490 consecutive cases. Am J Surg Pathol. 1995;19:1267–71.

    Article  CAS  PubMed  Google Scholar 

  6. Tinnemans JG, Wobbes T, Holland R, Hendriks JH, van der Sluis RF, Lubbers EJ, et al. Mammographic and histopathologic correlation of nonpalpable lesions of the breast and the reliability of frozen section diagnosis. Surg Gynecol Obstet. 1987;165:523–9.

    CAS  PubMed  Google Scholar 

  7. Murphy BL, Gonzalez AB, Keeney MG, Chen B, Conners AL, Henrichsen TL, et al. Ability of intraoperative pathologic analysis of ductal carcinoma in situ to guide selective use of sentinel lymph node surgery. Am Surg. 2018;84:537–42.

    PubMed  Google Scholar 

  8. Association of Directors of Anatomic and Surgical Pathology. Immediate management of mammographically detected breast lesions. Am J Surg Pathol. 1993;12:850–1.

    Google Scholar 

  9. Fessia L, Ghiringhello B, Arisio R, Botta G, Aimone V. Accuracy of frozen section diagnosis in breast cancer detection. A review of 4436 biopsies and comparison with cytodiagnosis. Pathol Res Pract. 1984;179:61–6.

    Article  CAS  PubMed  Google Scholar 

  10. Kaufman Z, Lew S, Griffel B, Dinbar A. Frozen-section diagnosis in surgical pathology. A prospective analysis of 526 frozen sections. Cancer. 1986;57:377–9.

    Article  CAS  PubMed  Google Scholar 

  11. Esteban JM, Zaloudek C, Silverberg SG. Intraoperative diagnosis of breast lesions. Comparison of cytologic with frozen section technics. Am J Clin Pathol. 1987;88:681–8.

    Article  CAS  PubMed  Google Scholar 

  12. De Rosa G, Boschi R, Boscaino A, Petrella G, Vetrani A, Palombini L, et al. Intraoperative cytology in breast cancer diagnosis: comparison between cytologic and frozen section techniques. Diagn Cytopathol. 1993;9:623–31.

    Article  PubMed  Google Scholar 

  13. Veneti S, Ioannidou-Mouzaka L, Toufexi H, Xenitides J, Anastasiadis P. Imprint cytology. A rapid, reliable method of diagnosing breast malignancy. Acta Cytol. 1996;40:649–52.

    Article  CAS  PubMed  Google Scholar 

  14. Spivack B, Khanna MM, Tafra L, Juillard G, Giuliano AE. Margin status and local recurrence after breast-conserving surgery. Arch Surg. 1994;138:1371–4.

    Google Scholar 

  15. Schnitt SJ, Abner A, Gelman R, Connolly JL, Recht A, Duda RB, et al. The relationship between microscopic margins of resection and the risk of local recurrence in patients with breast cancer treated with breast conserving surgery and radiation therapy. Cancer. 1994;74:1746–2751.

    Article  CAS  PubMed  Google Scholar 

  16. Graham RA, Homer MJ, Katz J, Rothschild J, Safaii H, Supran S. The pancake phenomenon contributes to the inaccuracy of margin assessment in patients with breast cancer. Am J Surg. 2002;184:89–93.

    Article  PubMed  Google Scholar 

  17. Cox CE, Ku NN, Reintgen D, Greenberg HM, Nicosia SV, Wangensteen S. Touch preparation cytology of breast lumpectomy margins with histologic correlation. Arch Surg. 1991;126:490–3.

    Article  CAS  PubMed  Google Scholar 

  18. Barthelmes L, Al Awa A, Crawford DJ. Effects of cavity margin shavings to ensure completeness of excision on local recurrence rates following breast conserving therapy. Eur J Surg Oncol. 2003;29:644–8.

    Article  CAS  PubMed  Google Scholar 

  19. Malik HZ, George WD, Mallon EA, Harnett AN, Macmillan RD, Purushotham AD. Margin assessment by cavity shaving breast-conserving surgery: analysis and follow-up of 543 patients. Eur J Surg Oncol. 1999;25:464–9.

    Article  CAS  PubMed  Google Scholar 

  20. Cao D, Lin C, Woo SH, Vang R, Tsangaris TN, Argani P. Separate cavity margin sampling at the time of initial breast lumpectomy significantly reduces the need for reexcisions. Am J Surg Pathol. 2005;29:1625–32.

    Article  PubMed  Google Scholar 

  21. Guidi AJ, Connoly JL, Harris JR, Shnitt SJ. The relationship between shaved margin and inked margin status in breast excision specimens. Cancer. 1997;70:1568–73.

    Article  Google Scholar 

  22. Rubin P, O’Honlon D, Browell D, Callanan K, Shrimankar J, Scott D, et al. Tumour bed biopsy detects the presence of multifocal disease in patients undergoing breast conservation therapy for primary breast carcinoma. Eur J Surg Oncol. 1996;22:23–6.

    Article  CAS  PubMed  Google Scholar 

  23. Riedl O, Fitzal F, Mader N, Dubsky P, Rudas M, Mittlboeck M, et al. Intraoperative frozen section analysis for breast-conserving therapy in 1016 patients with breast cancer. Eur J Surg Oncol. 2009;35:264–70.

    Article  CAS  PubMed  Google Scholar 

  24. Olson TP, Harter J, Munoz A, Mahvi DM, Breslin T. Frozen section analysis for intraoperative margin assessment during breast-conserving surgery results in low rates of re-excision and local recurrence. Ann Surg Oncol. 2007;14:2953–60.

    Article  CAS  PubMed  Google Scholar 

  25. Camp ER, McAuliffe PF, Gilroy JS, Morris CG, Lind DS, Mendenhall NP, et al. Minimizing local recurrence after breast conserving therapy using intraoperative shaved margins to determine pathologic tumor clearance. J Am Coll Surg. 2005;201:855–61.

    Article  PubMed  Google Scholar 

  26. Klimberg VS, Westbrook KC, Korourian S. Use of touch preps for diagnosis and evaluation of surgical margins in breast cancer. Ann Surg Oncol. 1998;5:220–6.

    Article  CAS  PubMed  Google Scholar 

  27. Valdes EK, Boolbol SK, Ali I, Feldman SM, Cohen JM. Intraoperative touch preparation cytology for margin assessment in breast-conservation surgery: does it work for lobular carcinoma? Ann Surg Oncol. 2007;14:2940–5.

    Article  PubMed  Google Scholar 

  28. Bakhshandeh M, Tutuncuoglu SO, Fischer G, Masood S. Use of imprint cytology for assessment of surgical margins in lumpectomy specimens of breast cancer patients. Diagn Cytopathol. 2007;35:656–9.

    Article  PubMed  Google Scholar 

  29. Weinberg E, Cox C, Dupont E, White L, Ebert M, Greenberg H, et al. Local recurrence in lumpectomy patients after imprint cytology margin evaluation. Am J Surg. 2004;188:349–54.

    Article  PubMed  Google Scholar 

  30. Veronesi U, Frante G, Galimberti V, Greco M, Luini A, Sacchini V, et al. Evaluation of resection margins after breast conservative surgery with monoclonal antibodies. Eur J Surg Oncol. 1991;17:338–41.

    CAS  PubMed  Google Scholar 

  31. Decker MR, Trentham-Dietz A, Loconte NK, Neuman HB, Smith MA, Punglia RS, et al. The role of intraoperative pathologic assessment in the surgical management of ductal carcinoma in situ. Ann Surg Oncol. 2016;23(9):2788–94.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Kuerer HM, Smith BD, Chavez-MacGregor AC, Barcenas CH, Santiago L, et al. DCIS margins and breast conservation: MD Anderson cancer center multidisciplinary practice guidelines and outcomes. J Cancer. 2017;8(14):2653–62.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Glorioso JM, Gonzalez Juerrero AB, Rodysill BS, Harmsen WS, Habermann EB, Carter JM, et al. Margin proximity correlates with local recurrence after mastectomy for patients not receiving adjuvant radiotherapy. Ann Surg Oncol. 2017;24:3148–56.

    Article  PubMed  Google Scholar 

  34. Gray RJ, Pockaj BA, Garvey E, Blair S. Intraoperative margin management in breast-conserving surgery: a systematic review of the literature. Ann Surg Oncol. 2018;25:18–27.

    Article  PubMed  Google Scholar 

  35. Giuliano AE, Hunt KK, Ballman KV, Beitsch PD, Whitworth PW, Blumencranz PW, et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis. A randomized clinical trial. JAMA. 2011;305(6):569–75.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Donker M, van Tienhoven G, Straver ME, Meijnen P, van de Velde CJ, Mansel RE, et al. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol. 2014;15(12):1303e10.

    Article  Google Scholar 

  37. van der MEM N, MTFD VP, Rutgers EJT. The intraoperative assessment of sentinel nodes – standards and controversies. Breast. 2017;34(Suppl 1):S64–9.

    Google Scholar 

  38. Tew K, Irwig L, Matthews A, Crowe P, Macaskill P. Metaanalysis of sentinel node imprint cytology in breast cancer. Br J Surg. 2005;92:1068–80.

    Article  CAS  PubMed  Google Scholar 

  39. Liu LC, Lang JE, Lu Y, Roe D, Hwang SE, Ewing CA, et al. Intraoperative frozen section analysis of sentinel lymph nodes in breast cancer patients. A meta-analysis and single-institution experience. Cancer. 2011;117:250–8.

    Article  PubMed  Google Scholar 

  40. Van Diest PJ, Torrenga H, Borgstein PJ, Pijpers R, Bleichrodt RP, Rahusen FD, et al. Reliability of intraoperative frozen section and imprint cytological investigation of sentinel lymph nodes in breast cancer. Histopathology. 1999;35:14–8.

    Article  PubMed  Google Scholar 

  41. Turner RR, Ollila DW, Krasne DL, Giuliano AE. Histopathologic validation of sentinel lymph node hypothesis for breast carcinoma. Ann Surg. 1997;226:271–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Viale G, Dell’orto P, Biasi MO, Stufano V, De Brito Lima LN, Paganelli G, et al. Comparative evaluation of an extensive histopathologic examination and a real-time reverse-transcription-polymerase chain reaction assay for mammaglobin and cytokeratin 19 on axillary sentinel lymph nodes of breast carcinoma patients. Ann Surg. 2008;247:136–42.

    Article  PubMed  Google Scholar 

  43. Klingler S, Marchal F, Rauch P, Kenouchi O, Chretien AS, Genin P, et al. Using one-step nucleic acid amplification (OSNA) for intraoperative detection of lymph node metastasis in breast cancer patients avoids second surgery and accelerates initiation of adjuvant therapy. Ann Oncol. 2013;24:2305–9.

    Article  CAS  PubMed  Google Scholar 

  44. Hughes SJ, Xi L, Raja S, Gooding W, Cole DJ, Gillanders WE, et al. A rapid, fully automated, molecular-based assay accurately analyzes sentinel lymph nodes for the presence of metastatic breast cancer. Ann Surg. 2006;243:389–98.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Tamaki Y, Akiyama F, Iwase T, Kaneko T, Tsuda H, Sato K, et al. Molecular detection of lymph node metastases in breast cancer patients: results of a multicenter trial using the one-step nucleic acid amplification assay. Clin Cancer Res. 2009;15:2879–84.

    Article  CAS  PubMed  Google Scholar 

  46. Lyman GH, Giuliano AE, Somerfield MR, Benson AB 3rd, Bodurka DC, Burstein HJ, et al. American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol. 2005;23:7703–20.

    Article  PubMed  Google Scholar 

  47. Shi F, Liang Z, Zhang Q, Wang C, Liu X. The performance of one-step nucleic acid amplification assay for intraoperative detection of sentinel lymph node macrometastasis in breast cancer: an updated meta-analysis. Breast. 2018;39:39–45.

    Article  PubMed  Google Scholar 

  48. Fitzgibbons PL, Page DL, Weaver D, Thor AD, Allred DC, Clark GM, et al. Prognostic factors in breast cancer: College of American Pathologists Consensus Statement 1999. Arch Pathol Lab Med. 2000;124:966–78.

    CAS  PubMed  Google Scholar 

  49. Association of Directors of Anatomic and Surgical Pathology. Recommendations for processing and reporting of lymph node specimens submitted for evaluation of metastatic disease. Am J Clin Pathol. 2001;115:799–801.

    Article  Google Scholar 

  50. Viale G, Bosari S, Mazzarol G, Galimberti V, Luini A, Veronesi P, et al. Intraoperative examination of axillary sentinel lymph nodes in breast carcinoma patients. Cancer. 1999;85:2433–8.

    Article  CAS  PubMed  Google Scholar 

  51. Turner RR. Histopathologic processing of the sentinel lymph node. Semin Breast Dis. 2002;5:35–40.

    Google Scholar 

  52. Weaver DL, Krag DN, Ashikaga T, Harlow SP, O’Connell M. Pathologic analysis of sentinel and nonsentinel lymph nodes in breast carcinoma: a multicenter study. Cancer. 2000;88:1099–107.

    Article  CAS  PubMed  Google Scholar 

  53. Cserni G. Metastases in axillary sentinel lymph nodes in breast cancer as detected by intensive histopathological work up. J Clin Pathol. 1999;52:922–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Turner RR, Ollila DW, Stern S, Giuliano AE. Optimal histopathologic examination of the sentinel lymph node for breast carcinoma staging. Am J Surg Pathol. 1999;23:263–7.

    Article  CAS  PubMed  Google Scholar 

  55. Zhang PJ, Reisner RM, Nangia R, Edge SB, Brooks JJ. Effectiveness of multiple-level sectioning in detecting axillary nodal micrometastasis in breast cancer: a retrospective study with immunohistochemical analysis. Arch Pathol Lab Med. 1998;122:687–90.

    CAS  PubMed  Google Scholar 

  56. Weaver DL, Le UP, Dupuis SL, Weaver KA, Harlow SP, Ashikaga T, et al. Metastasis detection in sentinel lymph nodes: comparison of a limited widely spaced (NSABP protocol B-32) and a comprehensive narrowly spaced paraffin block sectioning strategy. Am J Surg Pathol. 2009;33:1583–9.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Kanngurn S, Chewatanakornkul S, Premprapha T, Thongsuksai P. Comparability of different pathologic protocols in sentinel lymph node evaluation an analysis of two step-sectioning methods for the same patients with breast cancer. Arch Pathol Lab Med. 2009;133:1437–40.

    PubMed  Google Scholar 

  58. Weaver DL. Pathologic evaluation of sentinel lymph nodes in breast cancer: a practical academic perspective from America. Histopathology. 2005;46:697–706.

    Article  Google Scholar 

  59. Harrison BT, Brock JE. Contemporary evaluation of breast lymph nodes in anatomic pathology. Am J Clin Pathol. 2018;150(1):4–17.

    Article  PubMed  Google Scholar 

  60. Wells CA, Heryet A, Brochier J, Gatter KC, Mason DY. The immunocytochemical detection of axillary micrometastases in breast cancer. Br J Cancer. 1984;50:193–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Kollias J, Gil PG, Chatterton B, Raymond W, Collins PJ. Sentinel node biopsy in breast cancer: recommendations for surgeons, pathologists, nuclear physicians and radiologists in Australia and new Zeeland. Aust N Z J Surg. 2000;70:132–6.

    Article  CAS  PubMed  Google Scholar 

  62. Cserni G. Histopathologic examination of the sentinel lymph nodes. Breast J. 2006;12(5 Suppl 2):S152–6.

    Article  PubMed  Google Scholar 

  63. Cserni G, Amendoeira I, Apostolikas N, Bellocq JP, Bianchi S, Boecker W, et al. Discrepancies in current practice of pathological evaluation of sentinel lymph nodes in breast cancer. Results of a questionnaire-based survey by the European Working Group for Breast Screening Pathology. J Clin Pathol. 2004;57:695–701.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Green FL, Page DL, Fleming ID, Fritz AG, Balch CM, Haller DG, et al. AJCC cancer staging manual. 6th ed. New York: Springer; 2002.

    Book  Google Scholar 

  65. Van Rijk MC, Peterse JL, Nieweg OE, Oldenburg HS, Rutgers EJ, Kroon BB. Additional axillary metastases and stage migration in breast cancer patients with micrometastasis or submicrometastasis in sentinel lymph nodes. Cancer. 2006;107:467–71.

    Article  PubMed  Google Scholar 

  66. Rivera M, Merlin S, Hoda RS, Gopalan A, Hoda SA. Minimal involvement of sentinel lymph node in breast carcinoma: prevailing concepts and challenging problems. Int J Surg Pathol. 2004;12:301–6.

    Article  PubMed  Google Scholar 

  67. Biddle DA, Evans HL, Kemp BL, El-Naggar AK, Harvell JD, White WL, et al. Intraparenchymal nevus cell aggregates in lymph nodes: a possible diagnostic pitfall with malignant melanoma and carcinoma. Am J Surg Pathol. 2003;27:673–81.

    Article  PubMed  Google Scholar 

  68. Ichihara S, Ikeda T, Kimura K, Hanatate F, Yamada F, Hasegawa M, et al. Coincidence of mammary and sentinel lymph node papilloma. Am J Surg Pathol. 2008;32:784–92.

    Article  PubMed  Google Scholar 

  69. Fitzpatrick-Swallow VL, Helin H, Cane P, Pinder SE. Synchronous ductal carcinoma in situ of the breast and within epithelial inclusions in an ipsilateral sentinel lymph node. Hum Pathol. 2013;44(1):142–4.

    Article  PubMed  Google Scholar 

  70. Diaz NM, Cox CE, Ebert M, Clark JD, Vrcel V, Stowell N, et al. Benign mechanical transport of breast epithelial cells to sentinel lymph nodes. Am J Surg Pathol. 2004;28(12):1641–5.

    Article  PubMed  Google Scholar 

  71. Moore KH, Thaler HT, Tan LK, Borgen BJ, Cody HS 3rd. Immunohistochemically detected tumor cells in the sentinel lymph nodes of patients with breast carcinoma: biologic metastasis or procedural artifact? Cancer. 2004;100:929–34.

    Article  PubMed  Google Scholar 

  72. Nagi C, Bleiweiss I, Jaffer S. Epithelial displacement in breast lesions: a papillary phenomenon. Arch Path Lab Med. 2005;129:1465–9.

    PubMed  Google Scholar 

  73. Cox CE, Haddad F, Bass S, Cox JM, Ku NN, Berman C, et al. Lymphatic mapping in the treatment of breast cancer. Oncology. 1998;12:1283–92.

    CAS  PubMed  Google Scholar 

  74. Bass SS, Lyman GH, McCann CR, Ku NN, Berman C, Durand K, et al. Lymphatic mapping and sentinel lymph node biopsy. Breast J. 1999;5:288–95.

    Article  PubMed  Google Scholar 

  75. Pendas S, Dauway E, Giuliano R, Ku N, Cox CE, Reintgen DS. Sentinel node biopsy in ductal carcinoma in situ patients. Ann Surg Oncol. 2000;7:15–20.

    Article  CAS  PubMed  Google Scholar 

  76. Yi M, Krishnamurthy S, Kuerer HM, Meric-Bernstam F, Bedrosian I, Ross MI, et al. Role of primary tumor characteristics in predicting positive sentinel lymph nodes in patients with ductal carcinoma in situ or microinvasive breast cancer. Am J Surg. 2008;196:81–7.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Ballehaninna UK, Chamberlain RS. Utility of intraoperative frozen section examination of sentinel lymph nodes in ductal carcinoma in situ of the breast. Clin Breast Cancer. 2013;13:350–8.

    Article  PubMed  Google Scholar 

  78. Miller AR, Thomason VE, Yeh IT, Alrahwan A, Sharkey FE, Stauffer J, et al. Analysis of sentinel lymph node mapping with immediate pathologic review in patients receiving preoperative chemotherapy for breast carcinoma. Ann Surg Oncol. 2002;9:243–7.

    Article  PubMed  Google Scholar 

  79. Nason KS, Anderson BO, Byrd DR, Dunnwald LK, Eary JF, Mankoff DA, et al. Increased false negative sentinel node biopsy rates after preoperative chemotherapy for invasive breast carcinoma. Cancer. 2000;89:2187–94.

    Article  CAS  PubMed  Google Scholar 

  80. Tafra L, Verbanac KM, Lannin DR. Preoperative chemotherapy and sentinel lymphadenectomy for breast cancer. Am J Surg. 2001;182:312–5.

    Article  CAS  PubMed  Google Scholar 

  81. Julian TB, Patel N, Dusi D, Olson P, Nathan G, Jasnosz K, et al. Sentinel lymph node biopsy after neoadjuvant chemotherapy for breast cancer. Am J Surg. 2001;182:407–10.

    Article  CAS  PubMed  Google Scholar 

  82. Haid A, Tausch C, Lang A, Lutz J, Fritzsche H, Peschina W, et al. Is sentinel lymph node biopsy reliable and indicated after preoperative chemotherapy in patients with breast carcinoma? Cancer. 2001;92:1080–4.

    Article  CAS  PubMed  Google Scholar 

  83. Fernandez A, Cortes M, Benito E, Azpeitia D, Prieto L, Moreno A, et al. Gamma probe sentinel node localization and biopsy in breast cancer patients treated with a neoadjuvant chemotherapy scheme. Nucl Med Commun. 2001;22:361–6.

    Article  CAS  PubMed  Google Scholar 

  84. Balch GC, Mithani SK, Richards KR, Beauchamp RD, Kelley MC, et al. Lymphatic mapping and sentinel lymphadenectomy after preoperative therapy for stage II and III breast cancer. Ann Surg Oncol. 2003;10:616–21.

    Article  PubMed  Google Scholar 

  85. Ozmen V, Unal ES, Muslumanoglu ME, Igci A, Canbay E, Ozcinar B, et al. Axillary sentinel node biopsy after neoadjuvant chemotherapy. Eur J Surg Oncol. 2010;36:23–9.

    Article  CAS  PubMed  Google Scholar 

  86. Stearns V, Ewing CA, Slack R, Penannen MF, Hayes DF, Tsangaris TN. Sentinel lymphadenectomy after neoadjuvant chemotherapy for breast cancer may reliably represent the axilla except for inflammatory breast cancer. Ann Surg Oncol. 2002;9:235–42.

    Article  PubMed  Google Scholar 

  87. Mamounas EP, Brown A, Anderson S, Smith R, Julian T, Miller B, et al. Sentinel node biopsy after neoadjuvant chemotherapy in breast cancer: results from National Surgical Adjuvant Breast and Bowel Project Protocol B-27. J Clin Oncol. 2005;23:2694–702.

    Article  PubMed  Google Scholar 

  88. Boileau JF, Poirier B, Basik M, Holloway CMB, Gaboury L, Sideris L, et al. Sentinel node biopsy after neoadjuvant chemotherapy in biopsy-proven node-positive breast cancer: the SN FNAC study. J Clin Oncol. 2015;33:258–64.

    Article  PubMed  Google Scholar 

  89. Le-Petross HT, McCall LM, Hunt KK, Mittendorf EA, Ahrendt GM, Wilke LG, Ballman KV, Boughey JC. Axillary ultrasound identifies residual nodal disease after chemotherapy: results from the American College of Surgeons Oncology Group Z1071 trial (Alliance). AJR Am J Roentgenol. 2018;210(3):669–76.

    Article  PubMed  PubMed Central  Google Scholar 

  90. Schwentner L, Helms G, Nekljudova V, Ataseven B, Bauerfeind I, Ditsch N, et al. Using ultrasound and palpation for predicting axillary lymph node status following neoadjuvant chemotherapy – results from the multi-center SENTINA trial. Breast. 2017;31:202–7.

    Article  PubMed  Google Scholar 

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  1. Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey

    Ekrem Yavuz

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  1. Ekrem Yavuz
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  1. Department of Medical Oncology, Istanbul Medical Faculty, Oncology Institute, Istanbul University, Istanbul, Turkey

    Adnan Aydiner

  2. Department of General Surgery, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey

    Abdullah Igci

  3. Department of Surgical Oncology, Magee-Womens Hospital of the University of Pittsburgh, Pittsburgh, PA, USA

    Atilla Soran

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Yavuz, E. (2019). Intraoperative Pathological Examination of Breast Lesions. In: Aydiner, A., Igci, A., Soran, A. (eds) Breast Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-04606-4_15

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