Abstract
Purpose
Axillary lymph node assessment is an essential component of staging invasive breast cancer. One of the crucial issues in determining prognosis and treatment is the number of lymph nodes found by the pathologist. It is difficult to identify small lymph nodes among the surrounding fat. Fat-dissolving solutions have been introduced to dissolve fat, but their clinical benefit has yet to be evaluated. In this study, we compare 10% buffered formalin fixation and Carnoy's solution in revealing the axillary lymph node counts in modified radical mastectomy specimens.
Method
Fifty axillary tail specimens, taken from patients with invasive breast cancer who underwent modified radical mastectomy surgery, were randomly fixed in Carnoy’s solution or 10% buffered formalin. After 24–48 h of fixation, the total number and size of separated lymph nodes were examined by an expert pathologist.
Result
The average number of lymph nodes found in Carnoy and formalin solutions was 8 and 7.52, respectively, and the average number of metastatic lymph nodes found in these two solutions was 2.77 and 1.8, respectively. Moreover, the average size of the Carnoy group's lymph nodes was smaller than the formalin group, with no significant differences.
Conclusion
Compared to the formalin solution, taking into account the overall advantages of Carnoy's solution such as the same time of the preparation process, reduced carcinogenicity with only a slightly increased cost, using Carnoy's solution seems to be cost-effective in better staging and changing the patient's need for adjuvant treatments.
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Sagheb Movafagh, Z., Payandeh, A., Hassan Nejad, E. et al. Comparison of 10% Buffered Formalin Fixation and Carnoy's Solution in Revealing the Axillary Lymph Node Counts in Modified Radical Mastectomy Specimens. Indian J Gynecol Oncolog 21, 30 (2023). https://doi.org/10.1007/s40944-023-00709-5
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DOI: https://doi.org/10.1007/s40944-023-00709-5