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).

1. Occasionally, these nodes have already been biopsied. Verify clip presence by imaging the node or checking the requisition for specification. If uncertain, call the OR/check EPIC further.
2. Weigh and measure in 3 dimensions.
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. For a node from a patient not previously treated with chemo: freeze any grossly suspicious area.  If there is no grossly suspicious area or clip, freeze the entire node.
6. For a node from a patient previously treated with chemo: freeze a representative section from the most suspicious area. Only freeze one block of tissue unless further instructed by the surgeon/pathologist.
7. After frozen is complete, submit remaining slices of the node (no more than 2 per cassette) for permanent evaluation.
8. Please note the cassette which contains the clip site, if applicable.