BACKGROUND: The ideal pathologic assessment of sentinel lymph nodes (SLNs) in patients with breast carcinoma remains controversial. The authors evaluated how detailed assessment of SLNs using immunohistochemistry (IHC) and serial sectioning would affect treatment decisions and outcomes in patients with breast carcinoma who had negative SLNs on standard hematoxylin and eosin staining. METHODS: The SLNs from patients who were treated between June 1998 and June, 1999 and who had negative lymph node status determined by hematoxylin and eosin staining (n = 84 patients) were evaluated further with serial sectioning and cytokeratin IHC. Patients were offered adjuvant therapy based on primary tumor factors. RESULTS: The median patient age was 57 years, and the median tumor size was 1.2 cm. At a median follow-up of 40.2 months, 81 patients (96%) were alive with no evidence of disease, 1 patient was alive with disease, 1 patient had died of disease, and 1 patient had died of other causes. Fifteen patients (18%) had micrometastases identified on IHC. Of the total 84 patients, information regarding adjuvant therapy was not available for 5 patients. Of the remaining 79 patients, 10 patients (13%) were not offered adjuvant chemotherapy but had positive SLN status determined by IHC. SLN status based on IHC evaluation did not correlate with age (P = 0.077), tumor size (P = 0.717), grade (P = 0.148), estrogen receptor status (P = 1.000), or lymphovascular invasion (P = 0.274). Furthermore, IHC-detected positive SLN status did not correlate with distant metastasis (P = 0.372) or overall or distant metastasis-free survival (P = 0.543 and P = 0.540, respectively). CONCLUSIONS: Although the finding of SLN micrometastases by IHC may change management in > 12% of patients, preliminary results suggested that such micrometastases do not affect outcomes significantly. (c) 2005 American Cancer Society.
BACKGROUND: The ideal pathologic assessment of sentinel lymph nodes (SLNs) in patients with breast carcinoma remains controversial. The authors evaluated how detailed assessment of SLNs using immunohistochemistry (IHC) and serial sectioning would affect treatment decisions and outcomes in patients with breast carcinoma who had negative SLNs on standard hematoxylin and eosin staining. METHODS: The SLNs from patients who were treated between June 1998 and June, 1999 and who had negative lymph node status determined by hematoxylin and eosin staining (n = 84 patients) were evaluated further with serial sectioning and cytokeratin IHC. Patients were offered adjuvant therapy based on primary tumor factors. RESULTS: The median patient age was 57 years, and the median tumor size was 1.2 cm. At a median follow-up of 40.2 months, 81 patients (96%) were alive with no evidence of disease, 1 patient was alive with disease, 1 patient had died of disease, and 1 patient had died of other causes. Fifteen patients (18%) had micrometastases identified on IHC. Of the total 84 patients, information regarding adjuvant therapy was not available for 5 patients. Of the remaining 79 patients, 10 patients (13%) were not offered adjuvant chemotherapy but had positive SLN status determined by IHC. SLN status based on IHC evaluation did not correlate with age (P = 0.077), tumor size (P = 0.717), grade (P = 0.148), estrogen receptor status (P = 1.000), or lymphovascular invasion (P = 0.274). Furthermore, IHC-detected positive SLN status did not correlate with distant metastasis (P = 0.372) or overall or distant metastasis-free survival (P = 0.543 and P = 0.540, respectively). CONCLUSIONS: Although the finding of SLN micrometastases by IHC may change management in > 12% of patients, preliminary results suggested that such micrometastases do not affect outcomes significantly. (c) 2005 American Cancer Society.
Authors: Holm Eggemann; Atanas Ignatov; Madeleine Hetterich; Michael Gerken; Olaf Ortmann; Elisabeth C Inwald; Monika Klinkhammer-Schalke Journal: Breast Cancer Res Treat Date: 2021-03-15 Impact factor: 4.872
Authors: Igor Langer; Ulrich Guller; Carsten T Viehl; Holger Moch; Edward Wight; Felix Harder; Daniel Oertli; Markus Zuber Journal: Indian J Surg Oncol Date: 2010-08-07
Authors: Babak Ehteshami Bejnordi; Mitko Veta; Paul Johannes van Diest; Bram van Ginneken; Nico Karssemeijer; Geert Litjens; Jeroen A W M van der Laak; Meyke Hermsen; Quirine F Manson; Maschenka Balkenhol; Oscar Geessink; Nikolaos Stathonikos; Marcory Crf van Dijk; Peter Bult; Francisco Beca; Andrew H Beck; Dayong Wang; Aditya Khosla; Rishab Gargeya; Humayun Irshad; Aoxiao Zhong; Qi Dou; Quanzheng Li; Hao Chen; Huang-Jing Lin; Pheng-Ann Heng; Christian Haß; Elia Bruni; Quincy Wong; Ugur Halici; Mustafa Ümit Öner; Rengul Cetin-Atalay; Matt Berseth; Vitali Khvatkov; Alexei Vylegzhanin; Oren Kraus; Muhammad Shaban; Nasir Rajpoot; Ruqayya Awan; Korsuk Sirinukunwattana; Talha Qaiser; Yee-Wah Tsang; David Tellez; Jonas Annuscheit; Peter Hufnagl; Mira Valkonen; Kimmo Kartasalo; Leena Latonen; Pekka Ruusuvuori; Kaisa Liimatainen; Shadi Albarqouni; Bharti Mungal; Ami George; Stefanie Demirci; Nassir Navab; Seiryo Watanabe; Shigeto Seno; Yoichi Takenaka; Hideo Matsuda; Hady Ahmady Phoulady; Vassili Kovalev; Alexander Kalinovsky; Vitali Liauchuk; Gloria Bueno; M Milagro Fernandez-Carrobles; Ismael Serrano; Oscar Deniz; Daniel Racoceanu; Rui Venâncio Journal: JAMA Date: 2017-12-12 Impact factor: 56.272
Authors: Claire M T P Francissen; Pim J M Dings; Thijs van Dalen; Luc J A Strobbe; Hanneke W M van Laarhoven; Johannes H W de Wilt Journal: Ann Surg Oncol Date: 2012-08-14 Impact factor: 5.344