BACKGROUND: Little evidence of the impact of immunohistochemical analysis (IHC) on the indications for adjuvant therapies is available. This study determined the modification rate of adjuvant chemotherapy and lymph node area radiotherapy using IHC and its impact on survival. PATIENTS AND METHODS: Between 2001 and 2005, 416 patients underwent surgery for invasive breast cancer with sentinel lymph node (SLN) biopsy. RESULTS: A total of 112 patients had positive SLNs: 12.5% isolated tumor cells, 35.7% micrometastasis and 51.8% macrometastasis. Only 4% of patients (14 out of 342 patients) had modified indications for chemotherapy and 7% of patients (25 out of 342) for lymph node area radiotherapy due to IHC findings. CONCLUSION: IHC analysis led to modifications in adjuvant chemotherapy and lymph node area radiotherapy in 4% and 7% of patients, respectively. The prognosis of patients with nodal metastasis discovered by ultrastaging was similar to that for conventional Haematoxylin-Eosin-Safran (HES) staining. Our data support the use of SLN ultrastaging.
BACKGROUND: Little evidence of the impact of immunohistochemical analysis (IHC) on the indications for adjuvant therapies is available. This study determined the modification rate of adjuvant chemotherapy and lymph node area radiotherapy using IHC and its impact on survival. PATIENTS AND METHODS: Between 2001 and 2005, 416 patients underwent surgery for invasive breast cancer with sentinel lymph node (SLN) biopsy. RESULTS: A total of 112 patients had positive SLNs: 12.5% isolated tumor cells, 35.7% micrometastasis and 51.8% macrometastasis. Only 4% of patients (14 out of 342 patients) had modified indications for chemotherapy and 7% of patients (25 out of 342) for lymph node area radiotherapy due to IHC findings. CONCLUSION: IHC analysis led to modifications in adjuvant chemotherapy and lymph node area radiotherapy in 4% and 7% of patients, respectively. The prognosis of patients with nodal metastasis discovered by ultrastaging was similar to that for conventional Haematoxylin-Eosin-Safran (HES) staining. Our data support the use of SLN ultrastaging.