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Determination of sentinel lymph node (SLN) status in primary breast cancer by prospective use of immunohistochemistry increases the rate of micrometastases and isolated tumour cells: Analysis of 174 patients after SLN biopsy.

Rydén, Lisa LU ; Chebil, G; Sjöström, L; Pawlowski, R and Jönsson, Per-Ebbe LU (2007) In European Journal of Surgical Oncology 33(1). p.33-38
Abstract
Aim: The objective of the present study was to evaluate the prospective use of immunohistochemistry (IHC) for histopathological diagnosis of sentinel lymph node(s) (SLN) in primary breast cancer using stage migration and non-SLN metastases as endpoints in relation to metastatic involvement. Method: Serial sectioning and prospective use of IHC were applied to SLN examination in addition to routine haematoxylin-eosin staining in 174 consecutive patients with unifocal T1-T2 breast cancer included in a National Sentinel Node Study. Axillary lymph node dissection (ALND) was performed in all cases with macrometastases, micrometastases and isolated tumour cells (ITC). Results: The SLN was found in 173/174 patients and a metastatic foci was found... (More)
Aim: The objective of the present study was to evaluate the prospective use of immunohistochemistry (IHC) for histopathological diagnosis of sentinel lymph node(s) (SLN) in primary breast cancer using stage migration and non-SLN metastases as endpoints in relation to metastatic involvement. Method: Serial sectioning and prospective use of IHC were applied to SLN examination in addition to routine haematoxylin-eosin staining in 174 consecutive patients with unifocal T1-T2 breast cancer included in a National Sentinel Node Study. Axillary lymph node dissection (ALND) was performed in all cases with macrometastases, micrometastases and isolated tumour cells (ITC). Results: The SLN was found in 173/174 patients and a metastatic foci was found in 50 patients including 28/50 with macrometastases, 16/ 50 with micrometastases and 6/50 with ITC. IHC detected 3/16 of the micrometastases and 4/6 of ITC. Stage migration from NO to N1mi was encountered in 3/132 patients by use of IHC. Non-SLN metastases were noted in 15/28 of patients with macrometastases and in 3/16 of patients with micrometastases, whereas no patient with ITC had additional metastases (p = 0.007). Conclusion: The prospective use of lHC and serial sectioning for histopathological diagnosis of SLNs increased the detection rate of N1mi and ITC, but only 3/132 patients were stage-migrated by use of IHC. Patients with ITC did not have any risk of non-SLN metastases, supporting that ALND can safely be omitted in this group of patients. (C) 2006 Elsevier Ltd. All fights reserved. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
metastasis, sentinel lymph node biopsy, primary breast cancer, immunohistochemistry, isolated tumour cells, non-sentinel lymph node
in
European Journal of Surgical Oncology
volume
33
issue
1
pages
33 - 38
publisher
Elsevier
external identifiers
  • wos:000244842500006
  • scopus:33846385372
ISSN
1532-2157
DOI
10.1016/j.ejso.2006.11.007
language
English
LU publication?
yes
id
1de874e5-42b1-4153-bedd-30abcc590f62 (old id 163964)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17174513&dopt=Abstract
date added to LUP
2007-07-24 09:24:08
date last changed
2017-05-28 03:39:14
@article{1de874e5-42b1-4153-bedd-30abcc590f62,
  abstract     = {Aim: The objective of the present study was to evaluate the prospective use of immunohistochemistry (IHC) for histopathological diagnosis of sentinel lymph node(s) (SLN) in primary breast cancer using stage migration and non-SLN metastases as endpoints in relation to metastatic involvement. Method: Serial sectioning and prospective use of IHC were applied to SLN examination in addition to routine haematoxylin-eosin staining in 174 consecutive patients with unifocal T1-T2 breast cancer included in a National Sentinel Node Study. Axillary lymph node dissection (ALND) was performed in all cases with macrometastases, micrometastases and isolated tumour cells (ITC). Results: The SLN was found in 173/174 patients and a metastatic foci was found in 50 patients including 28/50 with macrometastases, 16/ 50 with micrometastases and 6/50 with ITC. IHC detected 3/16 of the micrometastases and 4/6 of ITC. Stage migration from NO to N1mi was encountered in 3/132 patients by use of IHC. Non-SLN metastases were noted in 15/28 of patients with macrometastases and in 3/16 of patients with micrometastases, whereas no patient with ITC had additional metastases (p = 0.007). Conclusion: The prospective use of lHC and serial sectioning for histopathological diagnosis of SLNs increased the detection rate of N1mi and ITC, but only 3/132 patients were stage-migrated by use of IHC. Patients with ITC did not have any risk of non-SLN metastases, supporting that ALND can safely be omitted in this group of patients. (C) 2006 Elsevier Ltd. All fights reserved.},
  author       = {Rydén, Lisa and Chebil, G and Sjöström, L and Pawlowski, R and Jönsson, Per-Ebbe},
  issn         = {1532-2157},
  keyword      = {metastasis,sentinel lymph node biopsy,primary breast cancer,immunohistochemistry,isolated tumour cells,non-sentinel lymph node},
  language     = {eng},
  number       = {1},
  pages        = {33--38},
  publisher    = {Elsevier},
  series       = {European Journal of Surgical Oncology},
  title        = {Determination of sentinel lymph node (SLN) status in primary breast cancer by prospective use of immunohistochemistry increases the rate of micrometastases and isolated tumour cells: Analysis of 174 patients after SLN biopsy.},
  url          = {http://dx.doi.org/10.1016/j.ejso.2006.11.007},
  volume       = {33},
  year         = {2007},
}