Abstract:
Objective To investigate the accuracy and clinical value of rapid on-site evaluation (ROSE) in sentinel lymph node biopsy (SLNB) of breast cancer.
Methods Three-hundred and seventy-five patients diagnosed with breast cancer at Yunnan Tumor Hospital from December 2019 to December 2021 were enrolled. One-hundred and ninety-five patients (group A) diagnosed with early breast cancer underwent SLNB alone, and 180 patients (group B) with locally advanced breast cancer underwent SLNB after neoadjuvant therapy. ROSE was used intraoperatively for rapid evaluation and diagnosis of 444 and 479 SLNs in group A and B, respectively. Paraffin was used as the gold standard to compare the diagnostic results. Meanwhile, intraoperative Papanikolaou (PAP) and hematoxylin and eosin (H & E) staining results between the two groups were compared to evaluate the diagnostic accuracy, sensitivity, and specificity of ROSE by McNemar test. The receiver operating characteristic (ROC) curve of each detection method was drawn, and the area under the ROC curve (AUC) was calculated.
Results The average diagnosis time of ROSE was 6.53 min/case. The AUC of group A in ROSE was 0.929, with 82.35% sensitivity and 97.56% specificity. The AUC of group B in ROSE was 0.961, with 93.81% sensitivity and 98.43% specificity. The diagnostic results of ROSE showed no statistical differences on using other detection methods(P=0.180, P=1.000).
Conclusions ROSE can improve the diagnostic efficiency while reducing the diagnostic cost of SLNB for breast cancer. Moreover, apart from having good clinical application and popularization value, it is expected to become a new method for intraoperative SLNB assessment.