Accuracy of intraoperative assessment of sentinel lymph nodes in breast cancer patients

Fakier, Ghaalied

Accuracy of intraoperative assessment of sentinel lymph nodes in breast cancer patients

Thesis / Dissertation

2026

Publisher

University of Cape Town

Department

Department of Pathology

Faculty

Faculty of Health Sciences

Abstract

Breast cancer remains a leading cause of cancer-related morbidity and mortality globally. Accurate staging is essential for appropriate management, yet breast cancer staging practices vary and are not universally standardized. Intraoperative sentinel lymph node biopsy (SLNB) with frozen section (FS) analysis is commonly employed to detect axillary lymph node metastases. When nodal metastases are identified, axillary lymph node dissection (ALND) is often performed. However, ALND is associated with significant morbidity and can negatively impact quality of life. The increasing use of neoadjuvant chemotherapy (NAC) and radiotherapy has the potential to downstage disease, but intraoperative FS analysis remains relevant, identifying individuals needing ALND. While international data supports this trend, variability in healthcare systems and patient populations limits the generalizability of these findings to the South African context.

Keywords

Breast carcinoma, frozen section, sentinel lymph node, ACOSOG Z011, axillary

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