Three-dimensional reconstruction of sentinel lymph nodes with metastatic breast cancer indicates three distinct patterns of tumour growth

Abstract

This methodology provides improved understanding of metastatic disease development and potentially could be used to develop strategies to improve techniques for its routine detection. Further studies are required in order to evaluate the prognostic and biological significance of the growth patterns identified.

Lymph-node metastases in invasive lobular carcinoma are different from those in ductal carcinoma of the breast

“…In a previous proof-of-principle study,35 we demonstrated that metastatic growth in ALN occurs in three distinct patterns: sinusoidal, nodular and diffuse. The preliminary results suggest that metastatic patterns may have prognostic significance with the sinusoidal pattern being related to a poor prognosis and the diffuse pattern with a good prognosis.…”

“…Three different growth patterns were noted within the LNs; sinusoidal, where the tumour cells were present within the subcapsular sinus of the ALN; nodular, where the tumour cells formed a clump, or nodule, of tightly packed cells in the cortex and and/or medulla of the node; and diffuse, where the tumour cells were dispersed through the cortex and/or medulla of the node in a diffuse spreading pattern. In some sections, only one growth pattern was seen, whereas in others they were seen in combination 35. If a pattern combination was present, the predominant pattern was noted.…”

“…This cohort included T1 and T2 tumour (size ranging from 0.5 to 5 cm, median 2 cm). The immunohistochemistry and bright-field microscopic analysis of the metastatic pattern were performed as previously described 35 42. Briefly, from each of the 246 cases, all formalin-fixed, paraffin-embedded (FFPE) SLN blocks were sectioned at 4 μm onto charged slides (X-tra Adhesive micro slides, Surgipath Europe Ltd), dried overnight at 37°C and then stained using standard Avidin–Biotin Complex (ABC; Dako Ltd, Denmark).…”

3D architecture of Ductal Carcinoma in situ from image reconstructions

“…Early 3D reconstructions using serial sections involved a laborious process involving taking camera lucida pictures of sections, cutting and stacking the resulting plates, and building a 3D model of the underlying structure [5]. With the development of new technologies, it is now possible to combine high resolution serial sections in silico to create a 3D image of breast cancer [6][7]. For example, in [6], the authors mapped invasive breast cancer in a 1x1x1 cm tissue sample and built a 3D representation.…”

“…For example, in [6], the authors mapped invasive breast cancer in a 1x1x1 cm tissue sample and built a 3D representation. The spread of metastatic growth could also be visualized from 3D reconstructions of sentinel lymph nodes [7]. Another germane investigation examined the 3D ductal structure of a normal breast [8] and determined the branching and independence of the ducts, including some with DCIS.…”