Intraoperative Examination of Sentinel Lymph Nodes by Ultrarapid Immunohistochemistry

: The recently developed method of ultrarapid immunohistochemistry (IHC) was applied to the intraoperative examination of sentinel lymph nodes (SLNs) in breast cancer patients. In a prospective study of 50 patients with invasive breast carcinomas, a total of 60 SLNs were studied. Among them, 33 SLNs...

Full description

Saved in:
Bibliographic Details
Published in:The breast journal 2003-07, Vol.9 (4), p.277-281
Main Authors: Nährig, Jörg M., Richter, Thomas, Kuhn, Walther, Avril, Norbert, Flatau, Birgit, Kowolik, Jurgen, Höfler, Heinz, Werner, Martin
Format: Article
Language:English
Subjects:
Adult
Aged
Antibodies, Monoclonal
Breast Neoplasms - pathology
Carcinoma, Ductal, Breast - pathology
Carcinoma, Lobular - pathology
Carcinoma, Medullary - pathology
Female
frozen section
Frozen Sections
Humans
Immunohistochemistry - methods
Immunohistochemistry - standards
Intraoperative Care
intraoperative ultrarapid immunohistochemistry
isolated tumor cells
Lymphatic Metastasis - pathology
micrometastasis
Middle Aged
Predictive Value of Tests
Prospective Studies
Sensitivity and Specificity
sentinel lymph node
Sentinel Lymph Node Biopsy - methods
Sentinel Lymph Node Biopsy - standards
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:: The recently developed method of ultrarapid immunohistochemistry (IHC) was applied to the intraoperative examination of sentinel lymph nodes (SLNs) in breast cancer patients. In a prospective study of 50 patients with invasive breast carcinomas, a total of 60 SLNs were studied. Among them, 33 SLNs from 30 patients were studied intraoperatively using a direct immunoperoxidase method with anticytokeratin antibody clone MNF116. This technique has a turnaround time of less than 20 minutes Ultrarapid IHC revealed 15 positive SLNs compared to 14 positive SLNs using hematoxylin and eosin (H&E) frozen sections. The one SLN missed in H&E frozen sections presented with cytokeratin‐positive isolated tumor cells in the lymph node sinus. After paraffin embedding, H&E‐stained serial step sections of the SLN specimens detected another two patients with isolated tumor cells. We also examined the remaining axillary lymph nodes (ALNs) by H&E‐stained serial step paraffin sections. From 17 of the 30 patients with positive SLNs, 6 patients also had metastatic involvement of the ALNs of level I or II. Thus ultrarapid IHC was a very sensitive and rapid technique for the intraoperative detection of metastatic involvement of SLNs in breast cancer patients. This technique may be a useful complementary tool for the intraoperative study of SLNs, particularly in tumors that are a diagnostic challenge, such as lobular carcinoma.
ISSN:1075-122X
1524-4741
DOI:10.1046/j.1524-4741.2003.09405.x