Auto Text: “Insert breast sentinel node frozen”

Breast sentinel lymph nodes are sent for intraoperative evaluation because the presence or absence of metastatic disease dictates the subsequent intraoperative course (whether or not an axillary dissection is performed). Thus, all lymph nodes should be isolated, serially sectioned, and entirely frozen in the absence of a gross metastatic lesion.

1. Occasionally, these nodes have already been biopsied. CHECK EPIC/CALL OPERATING ROOM to see whether you need to be searching for a clip or seed (if the requisition form does not specify).
2. Weigh and measure in 3 dimensions. (X-ray if necessary to determine location of clip).
3. Dissect superficial fat away from node.
4. Serially section node at approximately 2 mm intervals (parallel to the long axis). Look for areas of necrosis, hemorrhage, fibrosis, or discoloration.
5. Freeze any grossly suspicious area, and/or any slice in which a clip is found (please note on intraoperative diagnosis sheet in which slice the clip was located). If there is no grossly suspicious area or clip, freeze the entire node.
6. After frozen is complete, submit slices of node and remainder of frozen tissue (no more than 2 per cassette) for permanent evaluation. Please note the slice in which the clip was originally located.