Immunohistochemical Evaluation of Sentinel Lymph Nodes in Breast Carcinoma Patients

Cohen, Cynthia; Alazraki, Naomi P.; Styblo, Toncred M.; Waldrop, Sandra M.; Grant, Sandra; Larsen, Travis

doi:10.1097/00129039-200212000-00002

Cited by 17 publications

(19 citation statements)

References 62 publications

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“…There were 11 prospective studies. Sentinel node status per node examined was reported by Cohen et al 34 , Yu et al 35 , Lee et al 19 and Van Diest et al 45 . The rest of the studies reported sentinel node status per patient.…”

Section: Study Results and Quality Appraisalmentioning

confidence: 94%

Meta-analysis of sentinel node imprint cytology in breast cancer

Tew

Irwig

Matthews

et al. 2005

British Journal of Surgery

184

113

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Section: Study Results and Quality Appraisalmentioning

confidence: 94%

Meta-analysis of sentinel node imprint cytology in breast cancer

Tew

Irwig

Matthews

et al. 2005

British Journal of Surgery

184

113

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“…Algunos autores han observado que la presencia de micrometástasis e incluso de grupos celulares aislados se asocia con una reducción del intervalo libre de enfermedad, de la supervivencia y aumento de recurrencia [25][26] .…”

Section: Discussionunclassified

“…Parece que estos grupos celulares no son proliferativos y se duda de su viabilidad. 26,28,29 . En este momento los trabajos se centran en evaluar si existen diferencias pronósticas en el grupo de pacientes con metástasis del tipo micrometástasis y grupos celulares aislados en GC 5,25,30,31 .…”

Section: Discussionunclassified

“…En casi todas las revisiones, se reconoce la detección de algún caso de afectación de ganglios axilares cuando el GC ha sido negativo. El porcentaje oscila entre un 1% 12,20,26,32,33 y hasta un 16% 26 . Esta circunstancia no puede considerarse un falso negativo del ganglio centinela, sino una limitación irresoluble de la técnica del estudio del ganglio centinela, porque este ganglio es realmente negativo.…”

Section: Discussionunclassified

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Ganglio centinela en cáncer de mama: Estudio histológico de 67 casos

Córdoba¹,

Ederra

Amat³

et al. 2004

Anales Sis San Navarra

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RESUMENFundamento. La extirpación del ganglio centinela es una técnica quirúrgica muy extendida cuyo objetivo es evitar el vaciamiento axilar en pacientes con cáncer de mama en estadios iniciales. La determinación de la infiltración tumoral puede ser evidente en caso de macrometástasis (>2mm), o difícil de detectar en las micrometástasis (<2 mm). Por ello utilizamos en nuestro servicio un protocolo de cortes seriados, para incrementar nuestra capacidad de detección de micrometástasis. La realización de este protocolo resulta muy laborioso y supone un alto costo, por lo que se debe estudiar su efectividad y eficacia. Material y métodos.Hemos revisado los 67 ganglios centinelas correspondientes a 48 pacientes con cáncer de mama tratadas en nuestro hospital en los últimos 3 años. Todas las muestras recibidas en el Servicio de Anatomía Patológica se incluyen en su totalidad. Sobre cada ganglio se realizan cortes seriados de 3 micras y entre ellos se profundiza 40 micras. Se realizan en total 14 cortes. Se alternan cada 5 cortes con inmunoticción con un cócktel de queratinas (AE1/AE3) con cortes teñidos con hematoxilina-eosina.Resultados. Se extirparon 67 ganglios centinela de 48 pacientes. Se detectaron 14 positivos (20%). De dichas metástasis, 6 fueron macrometástasis >2mm, 5 fueron micrometástasis <2 mm y 3 grupo celular aislado (entre 0,2 y 2 mm) . En 6 casos (43%), las metástasis sólo se hicieron patentes con la tinción de queratina en los cortes seriados. Se realizó resección axilar en 44 casos. Conclusiones.El estudio histológico del ganglio centinela permite evaluar el estatus de infiltración tumoral de los ganglios axilares y reducir en gran medida las linfadenectomías axilares.El estudio convencional del ganglio centinela (con un único corte) resulta insuficiente para el diagnóstico de la infiltración tumoral. En nuestra serie el estudio histológico mediante un protocolo de cortes seriados nos ha permitido detectar un 43% de metástasis en ganglio centinela que no eran evidentes en el corte inicial.Palabras clave. Ganglio centinela. Carcinoma de mama. Queratina. ABSTRACTBackground. The extirpation of the sentinel node is a widespread surgical technique whose aim is to avoid axillary resection in patients with breast cancer at early stages. Determination of tumoral infiltration can be evident in the case of macrometastasis (>2mm), or difficult to detect in micrometastasis (<2mm). For this reason we use a protocol of serialized sections, to increase our capacity for detecting micrometastasis. Realisation of this protocol is highly laborious and represents a high cost, thus its effectiveness and efficacy must be studied.

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“…In particular the development of multisectioning and immunohistochemistry (IHC) staining techniques has been reported to increase the rate of detection of malignant disease by up to 33% [66][67][68] . IHC can be particularly beneficial in patients with invasive lobular cancer [69,70] .…”

Section: Pathologymentioning

confidence: 99%

What the clinician wants to know: radiation oncology perspective

Leer

2005

Cancer Imaging

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The delineation of the target volume, i.e. the volume which should be irradiated with a therapeutic dose of irradiation, is of utmost importance in radiotherapy. Modern imaging techniques cannot be missed in this process. Diagnosticians and radiation oncologists therefore should understand each other's needs and potential. Keywords: Radiotherapy; treatment planning; target volumes; biological target volume. Staging for radiotherapyRadiotherapy like surgery is a treatment for locoregional tumour growth. So, imaging modalities are extremely important for staging. Computerized tomography (CT), ultrasonography and magnetic resonance imaging (MRI) are used in the work-up of many tumours, e.g. in cervical cancer and head and neck tumours to detect lymph nodes, in rectal cancer to judge whether a free margin can be obtained to make the patient a suitable candidate for short term irradiation followed by surgery. New imaging modalities are also being introduced for staging such as fluorodeoxy glucose positron emission tomography (FDG-PET) scanning in lung cancer and MR lymphography with nanoparticles in prostate cancer. Image guided radiotherapy volumesWhereas surgery is tumour eradication under direct vision, radiotherapy is tumour eradication under indirect vision. So, imaging is of extreme importance for radiotherapy planning. In radiation oncology the target volume is that part of the body where a therapeutic dose of irradiation should be applied. This target volume is subdivided into several subsets: the gross tumour target volume (GTV), the clinical target volume (CTV) and the planning target volume (PTV). The GTV and CTV have a biological background. The GTV is what you can see, measure or palpate. The CTV is the suspected microscopic extension of the disease, and as in surgery, radiation oncologists also take a margin around the visible tumour. The GTV can include regional lymph nodes when microscopic spread to lymph nodes is expected; and when they should be treated electively, one could consider this as a nodal CTV. The PTV is a geometric and not a biological concept. This volume by two margins takes into account organ movement (internal margin) and positioning in accuracies and inaccuracies of the irradiation delivering equipment (set-up margin). The PTV is created to ensure that the therapeutic dose is indeed delivered to the CTV.Although one could imagine that the delineation of the GTV is most simple, we have to realise that different imaging modalities 'see' tumours or organs differently, e.g. the size of the prostate is different on MRI than CT. What is the truth? Often radiation oncologists use both. Consequently image registration or image fusion has become of paramount importance. Like surgery, in radiotherapy we also do some harm to normal tissues. Healthy tissue is unavoidably irradiated. However, the radiation dose in these tissues should be kept below tolerance which means below the dose which creates clinically manifest severe damage. For this reason a fourth volume in the irradiated part ...

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Immunohistochemical Evaluation of Sentinel Lymph Nodes in Breast Carcinoma Patients

Cited by 17 publications

References 62 publications

Meta-analysis of sentinel node imprint cytology in breast cancer

Meta-analysis of sentinel node imprint cytology in breast cancer

Ganglio centinela en cáncer de mama: Estudio histológico de 67 casos

What the clinician wants to know: radiation oncology perspective

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