Sentinel lymph nodes and breast carcinoma: analysis of 70 cases by frozen section

Abstract

BACKGROUNDThe sentinal node biopsy (SNB) is a reliable method for determining the status of the regional lymph nodes in patients with breast cancer. SNB technology is evolving rapidly, but no standardization has yet been accomplished. The aim of this study is to discuss the accuracy of this procedure and the optimal method for identifying micrometastases.METHODSWe collected data from 70 women with primary invasive breast carcinoma who underwent SNB for breast cancer. We examined two frozen sections levels from each half of each lymph node, as well as a cytology imprint before arriving at the frozen section diagnosis. Immunohistochemistry with pancytokeratin (AE1/AE3) was done on the paraffin sections. For the association between the lymph node size and the possibility of metastases, Student’s t test was used and a P value of less than 0.05 was regarded as significant.RESULTSThe number of patients with metastases in SNB was 19, from which 15 cases were correctly diagnosed in frozen sections/imprints and four cases were false negative. The axillary toilet from all cases with SNB metastases smaller than 2 mm showed no additional positive nodes. Lymph node diameter showed a significant association with sentinel node status (P<0.0001).CONCLUSIONFrozen section examination of SNB from patients with breast carcinoma is both specific (100%) and sensitive (79%). Diagnosis of lobular carcinoma can be difficult, and may require immunohistochemistry with cytokeratin for diagnosis. Small metastases in a non-optimal frozen section may be difficult to discern. Cytology imprints add nothing to the diagnosis.

Cyclooxygenase-2 and B-cell lymphoma-2 expression in cystitis glandularis and primary vesicle adenocarcinoma

“…Sections (5 μm thick) were cut from formalin-fixed, paraffin-embedded tissue blocks and stained with hematoxylin and eosin. Additional sections from appropriately selected blocks were cut for use in immunohistochemical analyses as described previously [ 13 , 14 ]. Two primary antibodies were used for immunochemical staining: monoclonal antibodies against COX-2 (monoclonal mouse anti-human D12; Santa Cruz Biotechnology, USA) and Bcl-2 (monoclonal mouse anti-human; Dako, Carpinteria, USA).…”

Increasing negative lymph node count predicts favorable OS and DSS in breast cancer with different lymph node-positive subgroups

“…In other words, positive lymph nodes examined on routine pathological analysis do not necessarily reflect lymph node metastasis. For approximately 9%-30% of breast cancer patients, there are micro-metastases in their axillary lymph nodes that are undetectable by routine pathological examination [ 23 ]. Lymph node micro-metastasis is a strong risk factor for tumor-free survival and metastatic recurrence [ 24 ].…”

Carbohydrate Microarrays Identify Blood Group Precursor Cryptic Epitopes as Potential Immunological Targets of Breast Cancer

“…This mAb was raised against epiglycanin, the major sialomucin glycoprotein (~500 kDa) of murine mammary adenocarcinoma TA3 cells [ 4 ]. It was initially called AE3 but was later renamed HAE3 [ 5 ] to avoid confusion with a commonly used anti-cytokeratin antibody in cancer research [ 6 , 7 ]. Interestingly, HAE3 was found to strongly cross-react with a number of human epithelial tumors in tissues, including lung, prostate, bladder, esophagus, and ovarian cancers [ 5 , 8 – 10 ].…”