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Editor’s note: Sentinel lymph node (SLN) mapping is a routine procedure for axillary staging in patients with early stage breast cancer. SLNs are sensitive and specific predictors of the status of non-SLNs in breast cancer, so a thorough and focused examination of those nodes with the highest probability of metastatic involvement is mandatory. The current authors conducted a prospective study to evaluate the feasibility and utility of using rapid cytokeratin immunostaining (RCI) of frozen section analysis of SLNs for the intraoperative detection of metastatic breast cancer. In addition, they compared the sensitivities and specificities of touch imprint cytology with those of frozen section analysis alone, RCI alone, touch imprint cytology plus frozen section analysis, and frozen section analysis plus RCI.