Sentinel lymph node biopsy: An audit of intraoperative assessment after introduction of a cytotechnology service

  • Jenny Edge Christiaan Barnard Memorial Hospital, Cape Town
  • Nola Lloyd Plastic Surgery Registrar, John Radcliffe Hospital, Oxford
  • Carol van der Velde Well Woman Diagnostics, Cape Town
  • Judith Whittaker Well Woman Diagnostics, Cape Town
DOI: https://doi.org/10.7196/sajsnew.7850
Keywords: Audit, Sentinel node biopsy, Cytotechnologist

Abstract

Objective. To audit results from intraoperative assessment of sentinel lymph node biopsy (SLNB) after the introduction of a cytotechnologist.

Study design. Since 2010, a cytotechnologist has been involved in the intraoperative assessment of SLNB in our breast cancer patients. The data from patients over the period 2006 - 2013 were used to compare outcomes before and after the introduction of a cytotechnology service. The database was divided into the periods 2006 - 2008 and 2010 - 2013 (2009 was the training period). 

Results. A total of 335 intraoperative SLNB assessments were performed: 165 between 2006 and 2008 (group 1) and 170 between 2010 and 2013 (group 2). In the study period (2010 - 2013), 2 (1%) metastatic deposits >2 mm were missed in patients with lobular carcinoma and 1 in a patient with ductal carcinoma. There was one (0.6%) false positive in a patient with a lobular carcinoma in each group. For patients with metastases >2 mm, group 1 had a sensitivity of 87% and a specificity of 99%. Group 2 had a sensitivity of 92% and a specificity of 99%. 

Conclusion. A trained cytotechnologist performing imprint cytology on SLNB to determine metastatic breast cancer can deliver results comparable with those of a group of pathologists.

Author Biographies

Jenny Edge, Christiaan Barnard Memorial Hospital, Cape Town
MB BChB, BSc, FRCS, MMed (Surg)
Nola Lloyd, Plastic Surgery Registrar, John Radcliffe Hospital, Oxford
MB BChB, MSc, DTM&H, MRCS
Carol van der Velde, Well Woman Diagnostics, Cape Town
MT
Judith Whittaker, Well Woman Diagnostics, Cape Town
MB ChB, MMed (Anat Path), FIAC
Published
2015-09-25
How to Cite
Edge, J., Lloyd, N., van der Velde, C., & Whittaker, J. (2015). Sentinel lymph node biopsy: An audit of intraoperative assessment after introduction of a cytotechnology service. South African Journal of Surgery, 53(2), 47-49. https://doi.org/10.7196/sajsnew.7850
Issue
Vol 53 No 2 (2015)
Section
General Surgery

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