Occult metastases in the sentinel lymph nodes of patients with early stage breast carcinoma

Frozen section diagnosis for axillary sentinel lymph nodes: the first six years

“…Unfortunately, many of the positive sentinel lymph nodes detected with step sections and immunohistochemistry have had very small numbers of tumor cells, and the clinical significance of micrometastatic carcinoma (0.2-2.0 mm) and submicrometastatic carcinoma (o0.2 mm) is uncertain. Studies on the clinical significance of these cells have had mixed results, [13][14][15][16][17] and the results of long-term follow-up are not yet available. A recent study by Moore et al 18 found evidence that sentinel lymph node tumor cells detected by immunohistochemistry only, might be due to so-called benign transport, and not represent true metastases.…”

Improved Detection of Metastases by Step Sectioning and Immuno-Histochemical Staining of Axillary Sentinel Nodes in Patients with Breast Carcinoma

“…Other studies have also demonstrated significant difference between single sectioning and step sectioning. However, there are other studies with similar (Ryden et al, 2007) or opposite results (Dowlatshahi et al, 1999, Fréneaux et al, 2002.…”

“…Several studies have reported similar sensitivity for both methods and some authors mentioned that SLN biopsy can be more sensitive than ALND if additional procedures such as immunohistochemical (IHC) staining be performed on the prepared slides of SLN (Giuliano et al, 1995;Dowlatshahi et al, 1999;Fréneaux et al, 2002;Stitzenberg et al, 2002). Performing IHC on all lymph nodes obtained from ALND is not cost-beneficial and labor-intensive, but can be performed on 1 or 2 lymph nodes harvested from SLN biopsy.…”

Immunohistochemistry and Reverse Transcriptase Polymerase Chain Reaction on Sentinel Lymph Nodes can Improve the Accuracy of Nodal Staging in Breast Cancer Patients

“…The staging superiority of SLNB with serial or step sectioning, with IHC, or with both, to ALND with routine histology has been demonstrated by several studies (18,(21)(22)(23)(24)(25)(26)). The optimal number and level of sections to be examined have not yet been determined (23,(27)(28)(29).…”

“…The optimal number and level of sections to be examined have not yet been determined (23,(27)(28)(29). It has been shown that on the basis of the average greatest dimension (20 µm) of a malignant ductal cell, a colony of 20 to 30 cells is very likely to be detected on sections at 250-µm levels (23).…”