Introduction: Sentinel lymph node (SLN) biopsy is the procedure of choice to determine the axillary involvement in breast cancer. The most important intraoperative evaluation methods are touch imprint cytology (TIC) and frozen section (FS). Each of these techniques has their own drawbacks and it is still unclear which are preferred.Methods: 97 consecutive patients with recently diagnosed breast cancer and no clinical evidence of lymph node involvement were included in the study. The SLN was determined with lymphoscintigraphy. TIC and FS were performed and their results were compared with permanent histopathologic examination.Results: Using permanent section as the gold standard TIC shoed sensitivity of 71.4%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 88.7%. These figures were 87.5%, 98.5%, 96.5%, and 95% for FS respectively.Conclusions: FS is a reliable method for SN involvement during surgery. Using frozen section during surgery can give the surgeon the opportunity to avoid second surgery. TIC is also a reliable method for intra-operative SN evaluation. Due to its high positive predictive value, TIC can be used first in the surgery room and FS can be saved for cases with negative results of TIC.

The imaging assessment of nodal disease can be challenging for the radiologist because there are multiple sites to review and differing opinions about criteria for abnormal nodes. The ability to accurately detect nodal metastases is improved with knowledge of the criteria for abnormal nodes, the nodal drainage patterns, and common imaging pitfalls. In this article, we introduce these basic concepts and review the appropriate approach for evaluation of metastatic cervical lymph nodes on cross-sectional neck imaging. This presentation would cover the following topics: criteria for abnormal nodes which includes size, morphology, margin and internal content of the lymph nodes ( cystic changes, Ca, etc. ), site Classification based on the system devised by American head and neck society and American academy of otolaryngology-head and neck surgery, features Important for Staging and the radiologist’ s role is to describe characteristics pertinent to the N staging, important features for Management such as extra capsular spread. It would also have a brief review of advanced imaging techniques for nodal metastases and the indications for FNA in head and neck lymphadenopathies.

Nearly four decades, Riviera classification, which is a clinically based system, was the only system for cervical adenopathy classification. The best possible classification of cervical nodal disease may be accomplished by using both clinical palpation and also information’s provided by imaging, because imaging can reveal clinically silent lymph nodes. Most head and neck tumors spread to the neck nodes as a part of their natural history, depending on the primary site. Up to 80% of patients with upper aero digestive mucosal malignancies will have cervical nodal metastasis At presentation. The occurrence of nodal metastasis has a profound effect on the management and prognosis of the patient’s .nodal metastasis is the most important prognostic factor in squalors cell carcinoma of the head and neck. In general it decreases the overall survival by half, and extra capsular spread worsens the prognosis by another half. Our purpose in this presentation is to review imaging classification of cervical lymph nodes.

Background: Cervical cancer is the second most common type of cancer among women. Effective screening programs can help cancer detection in early phases and reduce death. Metastasis to lymph nodes is one of the most prognostic factors in patients who underwent surgery. Also, a positive result from pathology report alert oncologist as a cause of death. Sentinel lymph node biopsy has been widely studied and clinically used for many types of cancer. Methods: Two techniques exist for detecting Sentinel node in cervical cancer, which are Blue dye and gamma probe with radioactive isotope (99mTc). Moreover, lymphoscintigraphy has many advantages over the stain method. Detecting the Sentinel node is performed via laparoscopy or laparotomy; former method is better and more accurate. Results: Various researchers have focused on this method and its positive results; its superiority against full lymphadenectomy has been declared in previous studies. Moreover, the role of Sentinel lymph nodes biopsy in cervical cancer is still being extensively studied. Sentinel lymph nodes (SLN) method has a higher accuracy level to detect metastasis. Conclusion: Hence, it can be considered as a more appropriate alternative for pelvic lymph node dissection (PLND), which is a standard technique. Altering the method to a standard clinical method needs in-depth researches and studies.