Pathologic examination of the axillary sentinel lymph nodes in patients with early-stage breast carcinoma: current and resolving controversies on the basis of the European Institute of Oncology experience

被引:20
作者
Viale, G
Mastropasqua, MG
Maiorano, E
Mazzarol, G
机构
[1] European Inst Oncol, Dept Pathol & Lab Med, I-20141 Milan, Italy
[2] Univ Milan, Sch Med, Milan, Italy
[3] Univ Bari, Dept Anat Pathol, Bari, Italy
关键词
breast carcinoma; sentinel node biopsy; micrometastasis;
D O I
10.1007/s00428-005-0103-3
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
Several controversial aspects of sentinel lymph node biopsy (SLNB) for patients with early-stage, node-negative breast carcinoma have been dealt with and resolved in the past decade since its introduction. Unfortunately, however, there is still no consensus on how best to examine sentinel lymph nodes (SLN) histologically. As a consequence, the protocols for SLN examination are remarkably variable in different institutions, leading to a very poor reproducibility of the data stemming from investigations on series of patients whose SLNs have been evaluated according to diverse protocols. Patient outcomes, however, can be optimised only by standardization of the whole procedure of SLNB, with particular reference to the histopathologic scrutiny. Lack of a standardized histopathologic protocol likely derives also from the uncertainties about the clinical implications of minimal lymph node involvement (isolated tumour cells and micrometastases) with regard both to the risk of additional metastases to non-sentinel lymph nodes of the same basin and to the prognostic value for patients' survival. This review aims at highlighting some of the controversial issues of the histopathologic examination of the SLNs, including the number of sections and cutting intervals, the use of immunohistochemistry and the role of molecular biology assays.
引用
收藏
页码:241 / 247
页数:7
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