Intraoperative Assessment of Breast Lymph Nodes Using Cancer Diagnostic Probe in Impedimetric Mode Publisher



Raei N ; Abdolahad M ; Raviani A
Source: Iranian Journal of Breast Diseases Published:2025

Abstract

Axillary lymph node dissection (ALND) was a standard component of breast cancer surgery for decades until the 1990s, when sentinel lymph node biopsy (SLNB) emerged as a less invasive and more precise alternative. SLNB revolutionized axillary staging by reducing complications and unnecessary dissections. Today, it is the preferred method in most breast cancer surgeries, rendering ALND nearly obsolete in many clinical scenarios (1). Initially, intraoperative assessment of sentinel lymph nodes was pivotal in determining the need for immediate ALND. This reduced the need for reoperations in patients with positive nodes. However, as the role of ALND declined, so did the emphasis on intraoperative node evaluation (2). Currently, ALND is reserved for select cases, such as clinically node-positive patients receiving neoadjuvant chemotherapy (NAC) (3) or luminal breast cancer patients with three or more involved nodes. In patients with only one or two positive nodes, ALND is generally avoided, and radiation therapy is often employed. However, current diagnostic techniques sometimes struggle to accurately quantify involved nodes, especially in cases involving small or confluent metastases (4). With the increased use of NAC, particularly in countries where patients present at more advanced stages, accurate lymph node evaluation remains essential. Traditional intraoperative diagnostic techniques, such as frozen section (FS) and touch preparation, although generally effective in luminal ductal carcinoma, have limited value post-NAC and in invasive lobular carcinoma (ILC). Moreover, FS prolongs surgery by 45 minutes to an hour, thereby increasing anesthesia duration and straining hospital resources (5). Thus, a critical clinical gap remains: current intraoperative methods are time-intensive, exhibit reduced sensitivity in post-NAC and ILC patients, and may be impractical in resource-limited settings. Copyright © 2025 Raei et al. Published by Breast Cancer Recearch Center, ACEC