Cytokeratin-positive cells in sentinel lymph nodes in breast cancer are not random events: Experience in patients undergoing prophylactic mastectomy Journal Article

  

Authors:	King, T. A.; Ganaraj, A.; Fey, J. V.; Tan, L. K.; Hudis, C.; Norton, L.; Cody, H. S. 3rd; Borgen, P. I.
Article Title:	Cytokeratin-positive cells in sentinel lymph nodes in breast cancer are not random events: Experience in patients undergoing prophylactic mastectomy
Abstract:	BACKGROUND. The incidence of immunohistochemistry (IHC)-detected epithelial cell displacement in sentinel lymph node (SLN) biopsy is unknown. In the current study, we address this question by examining the pattern of SLN involvement in patients undergoing prophylactic mastectomy (PM) at Memorial Sloan-Kettering Cancer Center (New York, NY). METHODS. Between January 1999 and January 2003, 5275 patients underwent SLN biopsy. Unilateral or bilateral PM with SLN biopsy was performed in 143 (2.7%) patients, representing 163 PM cases. RESULTS. Occult carcinoma was identified in 13 of 163 (8.0%) PM specimens. Two patients with occult invasive carcinoma had positive SLNs (hematoxylin and eosin). In the remaining 150 PM cases without occult carcinoma (130 patients), 89% underwent IHC analysis of the SLNs. Of these 130 patients, 43 (33%) had one or more prior biopsies in their "cancer-free" breast, a median of 43 days (range, 3-314 days) before PM. A total of 310 SLNs were examined by IHC (mean, 2.3 lymph nodes per PM case). Only 1 of 130 (0.8%) patients without occult carcinoma had an IHC-positive SLN. This patient had Stage IIIC carcinoma of the contralateral breast. IHC-positive SLNs were not identified in any of the 43 patients with a history of prior biopsy. Therefore, only 1 IHC-positive SLN was detected in 310 (0.3%) lymph nodes examined. CONCLUSIONS. IHC-positive cells in SLNs are rare in the absence of cancer and are not the result of previous breast instrumentation. Although the prognostic significance of IHC-positive cells remains controversial, the current study suggests that they are not random events. © 2004 American Cancer Society.
Keywords:	immunohistochemistry; adult; aged; middle aged; major clinical study; cancer staging; lymph nodes; cancer grading; sensitivity and specificity; sentinel lymph node; prospective studies; sentinel lymph node biopsy; protein analysis; breast cancer; mastectomy; incidence; breast neoplasms; biopsy; cancer invasion; immunoenzyme techniques; disease severity; breast carcinoma; micrometastasis; epithelial cells; neoplasm invasiveness; cytokeratin; keratins; lymph node biopsy; carcinoma, intraductal, noninfiltrating; occult cancer; humans; prognosis; human; female; priority journal; article; prophylactic mastectomy (pm); sentinel lymph node (sln) biopsy
Journal Title:	Cancer
Volume:	101
Issue:	5
ISSN:	0008-543X
Publisher:	Wiley Blackwell
Date Published:	2004-09-01
Start Page:	926
End Page:	933
Language:	English
DOI:	10.1002/cncr.20517
PROVIDER:	scopus
PUBMED:	15329899
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-4143115755&partnerID=40&md5=bd2a6776d27a58d86b3ccce65a7b378a
Notes:	Cancer -- Cited By (since 1996):32 -- Export Date: 16 June 2014 -- CODEN: CANCA -- Source: Scopus

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