Advanced SearchSearch Tips
Sentinel Node Biopsy Examination for Breast Cancer in a Routine Laboratory Practice: Results of a Pilot Study
facebook(new window)  Pirnt(new window) E-mail(new window) Excel Download
 Title & Authors
Sentinel Node Biopsy Examination for Breast Cancer in a Routine Laboratory Practice: Results of a Pilot Study
Khoo, Joon-Joon; Ng, Chen-Siew; Sabaratnam, Subathra; Arulanantham, Sarojah;
  PDF(new window)
Background: Examination of sentinel lymph node (SLN) biopsies provides accurate nodal staging for breast cancer and plays a key role in patient management. Procurement of SLNs and the methods used to process specimens are equally important. Increasing the level of detail in histopathological examination of SLNs increases detection of metastatic tumours but will also increase the burden of busy laboratories and thus may not be carried out routinely. Recommendation of a reasonable standard in SLN examination is required to ensure high sensitivity of results while maintaining a manageable practice workload. Materials and Methods: Twenty-four patients with clinically node-negative breast cancer were recruited. Combined radiotracer and blue dye methods were used for identification of SLNs. The nodes were thinly sliced and embedded. Serial sectioning and immunohistochemical (IHC) staining against AE1/AE3 were performed if initial H&E sections of the blocks were negative. Results: SLNs were successfully identified in all patients. Ten cases had nodal metastases with 7 detected in SLNs and 3 detected only in axillary nodes (false negative rate, FNR
Breast carcinoma;sentinel lymph nodes;thin-slicing;serial sectioning;immunohistochemical validation;
 Cited by
Application of automated image analysis reduces the workload of manual screening of sentinel lymph node biopsies in breast cancer, Histopathology, 2017, 71, 6, 866  crossref(new windwow)
Abdollahi A, Jangjoo A, Dabbagh Kakhki VR, et al (2010). Factors affecting sentinel lymph node detection failure in breast cancer patients using intradermal injection of the tracer. Rev Esp Med Nucl, 29, 73-7. crossref(new window)

Albertini JJ, Lyman GH, Cox C, et al (1996). Lymphatic mapping and sentinel node biopsy in the patient with breast cancer. JAMA, 276, 1818-22. crossref(new window)

Amir AS, Azar FP, Sahram N, et al (2012). Prevalence of occult metastases in axillary sentinel lymph nodes of breast carcinoma. Pol J Pathol, 63, 40-4.

Amoui M, Akbari ME, Tajeddini A, et al (2012). Value of sentinel lymph node biopsy in breast cancer surgery with simple pathology facilities--an Iranian local experience with a review of potential causes of false negative results. Asian Pac J Cancer Prev, 13, 5385-9. crossref(new window)

Andersson Y, Frisell J, Sylvan M, et al (2013). Causes of falsenegative sentinel node biopsy in patients with breast cancer. Br J Surg, 100, 775-83. crossref(new window)

Andersson Y, Frisell J, Sylvan M, et al ( 2010). Breast cancer survival in relation to the metastatic tumor burden in axillary lymph nodes. J Clin Oncol, 28, 2868-73. crossref(new window)

Barnwell JM, Arredondo MA, Kollmorgen D, et al (1998). Sentinel node biopsy in breast cancer. Ann Surg Oncol, 5, 126-30. crossref(new window)

Borgstein PJ, Pijpers R, Comans EF, et al (1998). Sentinel lymph node biopsy in breast cancer: guidelines and pitfalls of lymphoscintigraphy and gamma probe detection. J Am Coll Surg, 186, 275-83. crossref(new window)

Chagpar A, Pilavas J, Chao C, et al (2003). Sentinel lymph node biopsy for breast cancer:addressing the controversies. Cancer Therapy, 1, 223-32.

Chu KU, Turner RR, Hansen NM, et al (1999). Do all patients with sentinel node metastasis from breast carcinoma need complete axillary node dissection? Ann Surg, 229, 536-41. crossref(new window)

Cody HSr, Hill AD, Tran KN, et al (1999). Credentialing for breast lymphatic mapping: how many cases are enough? Ann Surg, 229, 723-6. crossref(new window)

Cox CE, Bass SS, McCann CR, et al (2000). Lymphatic mapping and sentinel lymph node biopsy in patients with breast cancer. Annu Rev Med, 51, 525-42. crossref(new window)

Cserni G (1999). Metastases in axillary sentinel lymph nodes in breast cancer as detected by intensive histopathological work up. J Clin Pathol, 52, 922-4. crossref(new window)

Cserni G, Gregori D, Merletti F, et al (2004). Meta-analysis of non-sentinel node metastases associated with micrometastatic sentinel nodes in breast cancer. Br J Surg, 91, 1245-52. crossref(new window)

Dauway EL, Giuliano R, Haddad F, et al (1999). Lymphatic mapping in breast cancer. Hematol Oncol Clin North Am, 13, 349-71. crossref(new window)

de Boer M, van Dijck JA, Bult P, et al (2010). Breast cancer prognosis and occult lymph node metastases, isolated tumour cells and micrometastases. J Natl Cancer Inst, 102, 410-25. crossref(new window)

Dowlatshahi K, Fan M, Snider HC, et al (1997). Lymph node micrometastases from breast carcinoma: reviewing the dilemma. Cancer, 80, 1188-97. crossref(new window)

Ellis IO (2005). Pathology reporting of breast disease. In 'NHS Breast Screening Programme (NHSBSP) publication. NHS Cancer Screening Programmes and The Royal College of Pathologists.', Eds Publication No.58. London,

Ensani F, Enayati L, Rajabiani A, et al (2013). Improved detection of metastases by step sectioning and immuno-histochemical staining of axillary sentinel nodes in patients with breast carcinoma. Asian Pac J Cancer Prev, 14, 5731-4. crossref(new window)

Fancellu A, Cottu P, Feo CF, et al (2012). Sentinel node biopsy in early breast cancer: lessons learned from more than 1000 cases at a single institution. Tumori, 98, 413-20. crossref(new window)

Fitzgibbons PL, Page DL, Weaver D, et al (2000). Prognostic factors in breast cancer. College of American Pathologists Consensus Statement 1999. Arch Pathol Lab Med, 124, 966-78.

Freneaux P, Nos C, Vincent-Salomon A, et al (2002). Histological detection of minimal metastatic involvement in axillary sentinel nodes: a rational basis for a sensitive methodology usable in daily practice. Mod Pathol, 15, 641-6. crossref(new window)

Gill J, Lovegrove R, Naessens K, et al (2011). Sentinel lymph node biopsy in breast cancer: an analysis of the maximum number of nodes requiring excision. Breast J, 17, 3-8. crossref(new window)

Giuliano AE, Dale PS, Turner RR, et al (1995). Improved axillary staging of breast cancer with sentinel lymphadenectomy. Ann Surg, 222, 394-401. crossref(new window)

Giuliano AE, Jones RC, Brennan M, et al (1997). Sentinel lymphadenectomy in breast cancer. J Clin Oncol, 15, 2345-50. crossref(new window)

Giuliano AE, Kirgan DM, Guenther JM, et al (1994). Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg, 220, 391-401. crossref(new window)

Gobardhan PD, Elias SG, Madsen EV, et al (2009 ). Prognostic value of micrometastases in sentinel lymph nodes of patients with breast carcinoma: a cohort study. Ann Oncol, 20, 41-8.

Goyal A, Newcombe RG, Chhabra A, et al (2006). Factors affecting failed localisation and false-negative rates of sentinel node biopsy in breast cancer--results of the ALMANAC validation phase. Breast Cancer Res Treat, 99, 203-8. crossref(new window)

Grabau D, Ryden L, Ferno M, et al (2011). Analysis of sentinel node biopsy - a single-institution experience supporting the use of serial sectioning and immunohistochemistry for detection of micrometastases by comparing four different histopathological laboratory protocols. Histopathol, 59, 129-38. crossref(new window)

Groen RS, Oosterhuis AW, Boers JE (2007). Pathologic examination of sentinel lymph nodes in breast cancer by a single haematoxylin-eosin slide versus serial sectioning and immunocytokeratin staining: clinical implications. Breast Cancer Res Treat, 105, 1-5.

Huvos A, Hutter R, Berg J (1971). Significance of axillary macrometastases and micrometastases in mammary cancer. Ann Surg, 173, 44-6. crossref(new window)

Jakub JW, Pendas S, Reintgen DS (2003). Current status of sentinel lymph node mapping and biopsy: facts and controversies. Oncologist, 8, 59-68. crossref(new window)

Jannink I, Fan M, Nagy S, et al (1998). Serial sectioning of sentinel nodes in patients with breast cancer: a pilot study. Ann Surg Oncol, 5, 310-4. crossref(new window)

Kamath VJ, Giuliano R, Dauway EL, et al (2001). Characteristics of the sentinel lymph node in breast cancer predict further involvement of higher-echelon nodes in the Axilla. Arch Surg, 136, 688-92. crossref(new window)

Keskek M, Balas S, Gokoz A, et al (2006). Re-evaluation of axillary skip metastases in the era of sentinel lymph node biopsy in breast cancer. Surg Today, 36, 1047-52. crossref(new window)

Kim T, Giuliano AE, Lyman GH (2006). Lymphatic mapping and sentinel lymph node biopsy in early-stage breast carcinoma: a metaanalysis. Cancer, 106, 4-16. crossref(new window)

Koslow SB, Eisenberg RE, Qiu Q, et al (2014 ). Sentinel lymph node biopsy is a reliable method for lymph node evaluation in neoadjuvant chemotherapy-treated patients with breast cancer. Am Surg, 80, 171-7.

Krag D, Weaver D, Ashikaga T, et al (1998). The sentinel node in breast cancer--a multicenter validation study. N Engl J Med, 339, 941-6. crossref(new window)

Krag DN, Anderson SJ, Julian TB, et al (2007). Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomised phase III trial. Lancet Oncol, 8, 881-8. crossref(new window)

Lee AHS, Ellis IO, Pinder SE, et al (2000). Pathological assessment of sentinel lymph-node biopsies in patients with breast cancer. Virchows Arch, 436, 97-101. crossref(new window)

Liberman L (2000). Pathologic analysis of sentinel lymph nodes in breast carcinoma. Cancer, 88, 971-7. crossref(new window)

Lin PP, Allison DC, Wainstock J, et al (1993). Impact of axillary lymph node dissection on the therapy of breast cancer patients. J Clin Oncol, 11, 1536-44. crossref(new window)

Lyman GH, Giuliano AE, Somerfield MR, et al (2005). American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol, 23, 7703-20. crossref(new window)

Madsen EV, Elias SG, van Dalen T, et al (2013). Predictive factors of isolated tumor cells and micrometastases in axillary lymph nodes in breast cancer. Breast, 22, 748-52. crossref(new window)

Martin RC, Chagpar A, Scoggins CR, et al (2005). Clinicopathologic factors associated with false-negative sentinel lymph-node biopsy in breast cancer. Ann Surg, 241, 1005-12. crossref(new window)

McMasters KM, Tuttle TM, Carlson DJ, et al (2000). Sentinel lymph node biopsy for breast cancer: a suitable alternative to routine axillary dissection in multi-institutional practice when optimal technique is used. J Clin Oncol, 18, 2560-6. crossref(new window)

National.Coordinating.Group.for.Breast.Screening.Pathology 1997. Pathology reporting in breast cancer screening, Sheffield:NHSBSP Publications.

Patani N, Mokbel K (2011). Clinical significance of sentinel lymph node isolated tumour cells in breast cancer. Breast Cancer Res Treat, 127, 325-34. crossref(new window)

Pendas S, Dauway EL, Giuliani R, et al (2000). Sentinel node biopsy in ductal carcinoma in situ patients. Ann Surg Oncol, 7, 15-20. crossref(new window)

Reintgen DS, Haddad F, Pendas S, et al (1998). Lymphatic mapping and sentinel lymph node biopsy. Sci Am, 17, 1-17.

Snider H, Dowlatshahi K, Fan M, et al (1999). Sentinel node biopsy in staging of breast cancer. Am J Surg, 176, 305-10.

Straver ME, Meijnen P, van Tienhoven G, et al (2010). Sentinel node identification rate and nodal involvement in the EORTC 10981-22023 AMAROS trial. Ann Surg Oncol, 17, 1854-61. crossref(new window)

Sun J, Yin J, Ning L, et al (2012). Clinicopathological characteristics of breast cancers with axillary skip metastases. J Invest Surg, 25, 33-6. crossref(new window)

Tafra L, Lannin DR, Swanson MS, et al (2001). Multicenter trial of sentinel node biopsy for breast cancer using both technetium sulfur colloid and isosulfan blue dye. Ann Surg, 233, 51-9. crossref(new window)

Tai P, Joseph KJ, Yu E (2011). Issues related to sentinel lymph node assessment in the management of breast cancer-what are relevant in pathology reports? Patholog Res Int, 2011.

Torrenga H, Rahusen FD, Meijer S, et al (2001). Sentinel node investigation in breast cancer; detailed analysis of the yield from step sectioning and immunohistochemistry. J Clin Pathol, 54, 550-2. crossref(new window)

Turner RR, Ollila DW, Krasne DL, et al (1997). Histopathologic validation of the sentinel lymph node hypothesis for breast carcinoma. Ann Surg, 226, 271-8. crossref(new window)

Turner RR, Ollila DW, Stern S, et al (1999). Optimal histopathologic examination of the sentinel lymph node for breast carcinoma staging. Am J Surg Pathol, 23, 263-7. crossref(new window)

van Diest PJ (1999). Histopathological workup of sentinel lymph nodes: how much is enough? J Clin Pathol, 52, 871-3. crossref(new window)

van Diest PJ, Peterse HL, Borgstein PJ, et al (1999). Pathological investigation of sentinel lymph nodes. Eur J Nucl Med, 26, 43-9. crossref(new window)

Verma R, Rajan SS, Verghese ET, et al (2014). Pathological evaluation of the staging axillary lymph nodes for breast cancer: a national survey in the United Kingdom. Histopathol, 65, 707-11. crossref(new window)

Veronesi U, Paganelli G, Galimberti V, et al (1997). Sentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph-nodes. Lancet, 349, 1864-7. crossref(new window)

Veronesi U, Paganelli G, Viale G, et al (1999). Sentinel lymph node biopsy and axillary dissection in breast cancer: results in a large series. J Natl Cancer Inst, 91, 368-73. crossref(new window)

Veronesi U, Paganelli G, Viale G, et al (2003). A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med, 349, 546-53. crossref(new window)

Vijayakumar V, Boerner PS, Jani AB, et al (2005). A critical review of variables affecting the accuracy and false-negative rate of sentinel node biopsy procedures in early breast cancer. Nucl Med Commun, 26, 395-405. crossref(new window)

Weaver D, Krag DN, Manna EA, et al (2002). Comparison of occult micrometastasis detection in breast caner sentinel lymph nodes using manual cytokeratin immunohistochemistry and image analysis. Mod Pathol, 15, 55A-6A.

Weaver DL (2010). Pathology evaluation of sentinel lymph nodes in breast cancer: protocol recommendations and rationale. Mod Pathol, 23, 26-32. crossref(new window)

Weaver DL, Krag DN, Ashikaga T, et al (2000). Pathologic analysis of sentinel and nonsentinel lymph nodes in breast carcinoma: a multicenter study. Cancer, 88, 1099-107. crossref(new window)

Wilking N, Rutqvist LE, Carstensen J, et al (1992). Prognostic significance of axillary nodal status in primary breast cancer in relation to the number of resected nodes. Stockholm Breast Cancer Study Group. Acta Oncol, 31, 29-35. crossref(new window)

Wong SL, Edwards MJ, Chao C, et al (2001a). The effect of lymphatic tumor burden on sentinel lymph node biopsy results. Breast J, 8, 192-8.

Wong SL, Edwards MJ, Chao C, et al (2001b). Sentinel lymph node biopsy for breast cancer: impact of the number of sentinel nodes removed on the false-negative rate. J Am Coll Surg, 192, 684-9. crossref(new window)

Zakaria S, Degnim AC, Kleer CG, et al (2007). Sentinel lymph node biopsy for breast cancer: how many nodes are enough? J Surg Oncol, 96, 554-9. crossref(new window)