How Much is Enough? Pathologic Evaluation of Sentinel Lymph Nodes

被引:0
|
作者
Cserni, Gabor [1 ,2 ]
机构
[1] Univ Szeged, Fac Med, Dept Pathol, EL-6720 Szeged, Hungary
[2] Bacs Kiskun Cty Teaching Hosp, Dept Pathol, Nyiri Ut 38, H-6000 Kecskemet, Hungary
关键词
Breast cancer; Sentinel lymph nodes; Macrometastasis; Micrometastasis; Isolated tumor cells; Intraoperative Frozen sections; Imprint cytology; One-step nucleic acid amplification; Quantitative real time reverse transcription polymerase chain reaction; Axillary lymphnode dissection;
D O I
10.1007/s12609-012-0073-9
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
It is well accepted that detailed analysis of sentinel lymph nodes (SLNs) may upstage breast cancer, but generally involves the identification of low-volume metastases (including isolated tumor cells and clusters). Although several guidelines recommend therapeutic interventions for micrometastases, there is also evidence supporting therapeutic interventions only for macrometastases. There is also evidence in support of means of regional disease control other than axillary lymph node dissection (ALND). The pathologic evaluation of SLNs should consider the clinical setting. Intraoperative assessment is indicated only if ALND is an immediate interventional option for SLN positivity. Generally, hematoxylin and eosin-stained sections taken at 2-mm step intervals are sufficient to disclose macrometastases, but if micrometastases are also considered in further treatment planning, smaller intervals and immunohistochemistry as well as quantitative molecular methods may also be considered.
引用
收藏
页码:89 / 95
页数:7
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