Abstract
The evaluation of sentinel lymph nodes (SLNs) for the presence of malignant epithelial cells is essential to the staging of breast cancer patients. Recently, increased attention has focused on the possibility that epithelial cells may reach SLNs by benign mechanical means, rather than by metastasis. The purpose of this study was to test the hypothesis that pre-SLN biopsy breast massage, which we currently use to facilitate the localization of SLNs, might represent a mode of benign mechanical transport. We studied 56 patients with invasive and/or in situ ductal carcinoma and axillary SLNs with only epithelial cells and/or cell clusters (≤0.2 mm in diameter and not associated with features of established metastases) detected predominantly in subcapsular sinuses of SLNs on hematoxylin and eosin- and/or anti-cytokeratin-stained sections. No patient had an SLN involved by either micro- or macro-metastatic carcinoma. Epithelial cells and cell clusters, ≤0.2 mm in size and without features of established metastases, occurred more frequently in the SLNs of patients who underwent pre-SLN biopsy breast massage (P < 0.001, χ2 test). The latter finding supports the hypothesis that pre-SLN biopsy breast massage is a mode of benign mechanical transport of epithelial cells to SLNs.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1641-1645 |
| Number of pages | 5 |
| Journal | American Journal of Surgical Pathology |
| Volume | 28 |
| Issue number | 12 |
| DOIs | |
| State | Published - Dec 1 2004 |
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Keywords
- Benign mechanical transport
- Breast cancer
- Occult micrometastasis
- Sentinel lymph node
ASJC Scopus subject areas
- Anatomy
- Surgery
- Pathology and Forensic Medicine
Cite this
Benign mechanical transport of breast epithelial cells to sentinel lymph nodes. / Diaz, Nils M.; Cox, Charles E.; Ebert, Mark; Clark, John D.; Vrcel, Vesna; Stowell, Nicholas; Sharma, Anu; Jakub, James W.; Cantor, Alan; Centeno, Barbara A.; Dupont, Elisabeth; Muro-Cacho, Carlos; Nicosia, Santo.
In: American Journal of Surgical Pathology, Vol. 28, No. 12, 01.12.2004, p. 1641-1645.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Benign mechanical transport of breast epithelial cells to sentinel lymph nodes
AU - Diaz, Nils M.
AU - Cox, Charles E.
AU - Ebert, Mark
AU - Clark, John D.
AU - Vrcel, Vesna
AU - Stowell, Nicholas
AU - Sharma, Anu
AU - Jakub, James W.
AU - Cantor, Alan
AU - Centeno, Barbara A.
AU - Dupont, Elisabeth
AU - Muro-Cacho, Carlos
AU - Nicosia, Santo
PY - 2004/12/1
Y1 - 2004/12/1
N2 - The evaluation of sentinel lymph nodes (SLNs) for the presence of malignant epithelial cells is essential to the staging of breast cancer patients. Recently, increased attention has focused on the possibility that epithelial cells may reach SLNs by benign mechanical means, rather than by metastasis. The purpose of this study was to test the hypothesis that pre-SLN biopsy breast massage, which we currently use to facilitate the localization of SLNs, might represent a mode of benign mechanical transport. We studied 56 patients with invasive and/or in situ ductal carcinoma and axillary SLNs with only epithelial cells and/or cell clusters (≤0.2 mm in diameter and not associated with features of established metastases) detected predominantly in subcapsular sinuses of SLNs on hematoxylin and eosin- and/or anti-cytokeratin-stained sections. No patient had an SLN involved by either micro- or macro-metastatic carcinoma. Epithelial cells and cell clusters, ≤0.2 mm in size and without features of established metastases, occurred more frequently in the SLNs of patients who underwent pre-SLN biopsy breast massage (P < 0.001, χ2 test). The latter finding supports the hypothesis that pre-SLN biopsy breast massage is a mode of benign mechanical transport of epithelial cells to SLNs.
AB - The evaluation of sentinel lymph nodes (SLNs) for the presence of malignant epithelial cells is essential to the staging of breast cancer patients. Recently, increased attention has focused on the possibility that epithelial cells may reach SLNs by benign mechanical means, rather than by metastasis. The purpose of this study was to test the hypothesis that pre-SLN biopsy breast massage, which we currently use to facilitate the localization of SLNs, might represent a mode of benign mechanical transport. We studied 56 patients with invasive and/or in situ ductal carcinoma and axillary SLNs with only epithelial cells and/or cell clusters (≤0.2 mm in diameter and not associated with features of established metastases) detected predominantly in subcapsular sinuses of SLNs on hematoxylin and eosin- and/or anti-cytokeratin-stained sections. No patient had an SLN involved by either micro- or macro-metastatic carcinoma. Epithelial cells and cell clusters, ≤0.2 mm in size and without features of established metastases, occurred more frequently in the SLNs of patients who underwent pre-SLN biopsy breast massage (P < 0.001, χ2 test). The latter finding supports the hypothesis that pre-SLN biopsy breast massage is a mode of benign mechanical transport of epithelial cells to SLNs.
KW - Benign mechanical transport
KW - Breast cancer
KW - Occult micrometastasis
KW - Sentinel lymph node
UR - http://www.scopus.com/inward/record.url?scp=9444259228&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=9444259228&partnerID=8YFLogxK
U2 - 10.1097/00000478-200412000-00014
DO - 10.1097/00000478-200412000-00014
M3 - Article
C2 - 15577685
AN - SCOPUS:9444259228
VL - 28
SP - 1641
EP - 1645
JO - American Journal of Surgical Pathology
JF - American Journal of Surgical Pathology
SN - 0147-5185
IS - 12
ER -