การศึกษาความแม่นยำในการวินิจฉัย Sentinel Axillary Lymph Node โดยเทียบระหว่าง Frozen Section กับ Permanent Section ในผู้ป่วยมะเร็งเต้านมที่ โรงพยาบาลพุทธชินราช พิษณุโลก

Apichat Chumtong

doi:10.1016/hscr.v41i1.279008

Authors

Apichat Chumtong Department of Anatomical Pathology, Buddhachinaraj Pisanulok Hospital

DOI:

https://doi.org/10.1016/hscr.v41i1.279008

Keywords:

Sentinel axillary lymph node, Frozen section, Breast cancer, Diagnostic accuracy

Abstract

ABSTRACT
Objective: To evaluate the diagnostic accuracy of frozen section examination of sentinel axillary lymph nodes compared with permanent section in breast cancer patients at Buddhachinaraj Phitsanulok Hospital.
Methods: A retrospective descriptive study was conducted including 265 female breast cancer patients who underwent sentinel axillary lymph node between 2015 and 2025. FS results were compared with permanent section, and sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated.
Results: The mean patient age was 58.5 years, with an average of 3.8 lymph nodes examined per case. Frozen section demonstrated a sensitivity of 92.7%, specificity of 98.1%, PPV of 92.7%, NPV of 98.1%, and overall accuracy of 97.0%. Most discrepancies were associated with micrometastasis and technical limitations of frozen section preparation.
Conclusions: Frozen section examination of sentinel axillary lymph node in breast cancer shows high diagnostic accuracy and plays an important role in intraoperative decision-making, effectively reducing the need for reoperation. Future improvements should incorporate adjunct techniques such as immunohistochemistry, molecular assays, and digital pathology consultation to enhance diagnostic sensitivity and service quality.

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