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 histopathologic laboratory protocols

Dorthe Grabau (1) , Lisa Rydén (2) , Marten Ferno (3) , Christian Ingvar (4)

1 Pathology
2 Surgery
3 Oncology
4 Department of Surgery

Abstract Aims. Detecting micrometastases (>0.2 mm and ≤2 mm/>200 cells) and isolated tumor cells (ITC) (≤0.2 mm/<200 cells) is important for staging of breast cancer patients. The aim of this study was to systematically compare several laboratory protocols used to detect metastases after initial intraoperative frozen section examination. Methods and results. Four different protocols for the work-up of sentinel lymph nodes (SLN) after frozen sectioning were applied in the routine diagnostic process from 2001-2009. In addition team work with a limited number of laboratory technicians and pathologists handling SLN was introduced in 2008. The present study shows overall significantly more node positive patients in the period where team work and intensive step sections including immunohistochemistry (IHC) was used (p=0.01). This resulted in 13% more patients found to have ITC and micrometastases compared with the result from a time period when only step sections were done. No rise in false negative frozen sections was seen. Conclusions. Future guidelines for pathologic work-up of sentinel nodes in women with breast cancer might include team work and IHC if frozen sections are used intraoperatively.

Mots clés: Medicine

Dorthe Grabau, Lisa Rydén, Marten Ferno, Christian Ingvar. 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 histopathologic laboratory protocols. Histopathology, 2011, 59 (1), pp.129. ⟨10.1111/j.1365-2559.2011.03881.x⟩. ⟨hal-00651159⟩