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; Chebil, G; Sjöström, L; Pawlowski, R; Jönsson, Per-Ebbe

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.

Mark

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)

Please use this url to cite or link to this publication: https://lup.lub.lu.se/record/163964

author

Rydén, Lisa ^LU

; Chebil, G ; Sjöström, L ; Pawlowski, R and Jönsson, Per-Ebbe ^LU

organization

publishing date

2007

type

Contribution to journal

publication status

published

subject

Surgery

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

additional info

The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Emergency medicine/Medicine/Surgery (013240200), Surgery (Lund) (013009000), Surgery Research Unit (013242220)

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

2016-04-01 12:02:44

date last changed

2022-04-05 08:50:33

@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}},
  keywords     = {{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          = {{https://lup.lub.lu.se/search/files/2757068/625803.pdf}},
  doi          = {{10.1016/j.ejso.2006.11.007}},
  volume       = {{33}},
  year         = {{2007}},
}

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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.