On the Problem of Sentinel Lymphatic Nodes Examination in Mammary Cancer

Overview

Objective:
Evaluation of present approaches to the investigation of sentinel lymph nodes in breast cancer.

Design:
A review article.

Setting:
Obstetrics and Gynecology Department, Institute of Pathology and Department of Clinical Oncology of 1st Faculty of Medicine and General Teaching Hospital, Prague.

Subject:
Sentinel lymph node biopsy can change surgical management of breast cancer and evaluation of regional lymph nodes. Sentinel nodes are reached first by the process of metastasis. Their status has been shown to rather accurately reflect the presence or absence of metastases in the axillary lymph nodes. The macrometastases (larger than 2 mm) are the most important ones. Step or serial sectioning and cytokeratins detection are necessary for findings of micrometastases (0.2–2 mm) or isolated tumor cells. Their prognostic significance is until now unclear and standard examination does not exist.

Conclusion:
Pathological examination of sentinel lymph nodes ought to identity all macrometastases (larger than 2 mm) as a minimum standard. Further investigations are necessary in order to evaluate the significance of micrometastases and isolated tumor cells and to find an optimal and standard processing.

Key words:
sentinel lymph node, breast cancer, metastasis