To Level or Not: Histological Examination of Sentinel Lymph Nodes in Patients with Breast Carcinoma

Abstract

Abstract Management of the axilla in patients with breast carcinoma has changed rapidly in recent years due to development of an increasingly conservative approach to axillary staging. Sentinel node examination plays a pivotal role in subsequent decision for axillary lymph node dissection. There is still no consensus on how best to examine SLNs histologically. The examination of sentinel node should be thorough enough whilst not missing clinically significant information. The main goal of sentinel lymph node examination is to detect all macrometastasis. In this study we have reviewed an extensive histological protocol to identify whether it resulted in detection of clinically significant metastatic deposits. Our study identified that one hematoxylineosin–stained section along with immunostaining for pancytokeratin from each block results in the detection of clinically significant metastases and hence recommended as the preferred method of pathologic evaluation. Keywords Axillary node examination; Breast carcinoma; Sentinel node Abbreviations ALND: Axillary Lymph Node Dissection; MiM: Micrometastasis; SLN: Sentinel Lymph Node