The role of cytokeratin immunohistochemical slain of axillary sentinel lymph nodes as a predictor of axillary lymph node dissection findings

L. Chinsoo Cho, Ann Spangkr, Phuc Nguyen, A. Marilyn Leitch, David Euhus, Hossein Saboorian

Research output: Contribution to journalArticle

Abstract

The significance of positive cytokeratin immunohistochemical(lHC) staining in sentinel axillary lymph nodes in breast cancer remains unclear. Authors reviewed a database of 904 consecutive patients participating in a sentinel lymph node(SLN) biopsy study at UTSW. There were 58 out of 904 patients (6.4%) who lacked evidence of SLN metastasis by hematoxylin-eosin stain but were found to have IHC positive cells in the SLN. Forty-seven of the 58 patients subsequently underwent axillary lymph node dissection (ALND). The characteristics of these 47 patients included a median age of 55 (37-76) and a median primary tumor size of 2.0 (0.4-7.2) cm. The location of the primary tumor included 25(53%) upper outer quadrant, 7(15%) upper inner quadrant, (11%) lower inner quadrant, 3(6%) lower outer quadrant, and 7(15%) between quadrants. Thirty-four (72%) of the patients had positive estrogen receptors (ER). Her-2-neu positive tumors were found in 12 (26%) of the patients. The median number of lymph nodes removed was 3 (1-7) for SLN biopsy and 17 (4-31) for ALND. There were two (4%) patients who had additional positive nodes found at ALND. One of the patients with a primary tumor size of 2.3 cm invasive ductal histology(IDC), ER ( + ), and Her-2-neu (-) had 1 mm metastasis in a SLN, but had 13 of 16 lymph nodes with metastasis on ALND. The other patient with a primär)- tumor size of 3.9 cm IDC, ER (-), and Her-2-neu (-) had three SLNs each with 1 mm metastasis and 2 of 9 lymph nodes with metastasis on ALND each containing 0.4 cm metastasis. In conclusion, the patients with only 1HC slain evidence of SLN metastasis have a low likelihood of additional metastasis at ALND. However, those patients who did have additional métastases had significant disease burden that would likely manifest as a clinical problem without ALND. Additional studies are required to better define parameters that predict for additional positive nodes at ALND.

Original languageEnglish (US)
Pages (from-to)514
Number of pages1
JournalCancer Journal
Volume9
Issue number6
StatePublished - 1996

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Keratins
Lymph Node Excision
Neoplasm Metastasis
Sentinel Lymph Node Biopsy
Estrogen Receptor beta
Lymph Nodes
Neoplasms
Histology
Sentinel Lymph Node
Hematoxylin
Eosine Yellowish-(YS)
Estrogen Receptors
Coloring Agents
Databases
Staining and Labeling
Breast Neoplasms

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

The role of cytokeratin immunohistochemical slain of axillary sentinel lymph nodes as a predictor of axillary lymph node dissection findings. / Chinsoo Cho, L.; Spangkr, Ann; Nguyen, Phuc; Marilyn Leitch, A.; Euhus, David; Saboorian, Hossein.

In: Cancer Journal, Vol. 9, No. 6, 1996, p. 514.

Research output: Contribution to journalArticle

Chinsoo Cho, L. ; Spangkr, Ann ; Nguyen, Phuc ; Marilyn Leitch, A. ; Euhus, David ; Saboorian, Hossein. / The role of cytokeratin immunohistochemical slain of axillary sentinel lymph nodes as a predictor of axillary lymph node dissection findings. In: Cancer Journal. 1996 ; Vol. 9, No. 6. pp. 514.
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title = "The role of cytokeratin immunohistochemical slain of axillary sentinel lymph nodes as a predictor of axillary lymph node dissection findings",
abstract = "The significance of positive cytokeratin immunohistochemical(lHC) staining in sentinel axillary lymph nodes in breast cancer remains unclear. Authors reviewed a database of 904 consecutive patients participating in a sentinel lymph node(SLN) biopsy study at UTSW. There were 58 out of 904 patients (6.4{\%}) who lacked evidence of SLN metastasis by hematoxylin-eosin stain but were found to have IHC positive cells in the SLN. Forty-seven of the 58 patients subsequently underwent axillary lymph node dissection (ALND). The characteristics of these 47 patients included a median age of 55 (37-76) and a median primary tumor size of 2.0 (0.4-7.2) cm. The location of the primary tumor included 25(53{\%}) upper outer quadrant, 7(15{\%}) upper inner quadrant, (11{\%}) lower inner quadrant, 3(6{\%}) lower outer quadrant, and 7(15{\%}) between quadrants. Thirty-four (72{\%}) of the patients had positive estrogen receptors (ER). Her-2-neu positive tumors were found in 12 (26{\%}) of the patients. The median number of lymph nodes removed was 3 (1-7) for SLN biopsy and 17 (4-31) for ALND. There were two (4{\%}) patients who had additional positive nodes found at ALND. One of the patients with a primary tumor size of 2.3 cm invasive ductal histology(IDC), ER ( + ), and Her-2-neu (-) had 1 mm metastasis in a SLN, but had 13 of 16 lymph nodes with metastasis on ALND. The other patient with a prim{\"a}r)- tumor size of 3.9 cm IDC, ER (-), and Her-2-neu (-) had three SLNs each with 1 mm metastasis and 2 of 9 lymph nodes with metastasis on ALND each containing 0.4 cm metastasis. In conclusion, the patients with only 1HC slain evidence of SLN metastasis have a low likelihood of additional metastasis at ALND. However, those patients who did have additional m{\'e}tastases had significant disease burden that would likely manifest as a clinical problem without ALND. Additional studies are required to better define parameters that predict for additional positive nodes at ALND.",
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T1 - The role of cytokeratin immunohistochemical slain of axillary sentinel lymph nodes as a predictor of axillary lymph node dissection findings

AU - Chinsoo Cho, L.

AU - Spangkr, Ann

AU - Nguyen, Phuc

AU - Marilyn Leitch, A.

AU - Euhus, David

AU - Saboorian, Hossein

PY - 1996

Y1 - 1996

N2 - The significance of positive cytokeratin immunohistochemical(lHC) staining in sentinel axillary lymph nodes in breast cancer remains unclear. Authors reviewed a database of 904 consecutive patients participating in a sentinel lymph node(SLN) biopsy study at UTSW. There were 58 out of 904 patients (6.4%) who lacked evidence of SLN metastasis by hematoxylin-eosin stain but were found to have IHC positive cells in the SLN. Forty-seven of the 58 patients subsequently underwent axillary lymph node dissection (ALND). The characteristics of these 47 patients included a median age of 55 (37-76) and a median primary tumor size of 2.0 (0.4-7.2) cm. The location of the primary tumor included 25(53%) upper outer quadrant, 7(15%) upper inner quadrant, (11%) lower inner quadrant, 3(6%) lower outer quadrant, and 7(15%) between quadrants. Thirty-four (72%) of the patients had positive estrogen receptors (ER). Her-2-neu positive tumors were found in 12 (26%) of the patients. The median number of lymph nodes removed was 3 (1-7) for SLN biopsy and 17 (4-31) for ALND. There were two (4%) patients who had additional positive nodes found at ALND. One of the patients with a primary tumor size of 2.3 cm invasive ductal histology(IDC), ER ( + ), and Her-2-neu (-) had 1 mm metastasis in a SLN, but had 13 of 16 lymph nodes with metastasis on ALND. The other patient with a primär)- tumor size of 3.9 cm IDC, ER (-), and Her-2-neu (-) had three SLNs each with 1 mm metastasis and 2 of 9 lymph nodes with metastasis on ALND each containing 0.4 cm metastasis. In conclusion, the patients with only 1HC slain evidence of SLN metastasis have a low likelihood of additional metastasis at ALND. However, those patients who did have additional métastases had significant disease burden that would likely manifest as a clinical problem without ALND. Additional studies are required to better define parameters that predict for additional positive nodes at ALND.

AB - The significance of positive cytokeratin immunohistochemical(lHC) staining in sentinel axillary lymph nodes in breast cancer remains unclear. Authors reviewed a database of 904 consecutive patients participating in a sentinel lymph node(SLN) biopsy study at UTSW. There were 58 out of 904 patients (6.4%) who lacked evidence of SLN metastasis by hematoxylin-eosin stain but were found to have IHC positive cells in the SLN. Forty-seven of the 58 patients subsequently underwent axillary lymph node dissection (ALND). The characteristics of these 47 patients included a median age of 55 (37-76) and a median primary tumor size of 2.0 (0.4-7.2) cm. The location of the primary tumor included 25(53%) upper outer quadrant, 7(15%) upper inner quadrant, (11%) lower inner quadrant, 3(6%) lower outer quadrant, and 7(15%) between quadrants. Thirty-four (72%) of the patients had positive estrogen receptors (ER). Her-2-neu positive tumors were found in 12 (26%) of the patients. The median number of lymph nodes removed was 3 (1-7) for SLN biopsy and 17 (4-31) for ALND. There were two (4%) patients who had additional positive nodes found at ALND. One of the patients with a primary tumor size of 2.3 cm invasive ductal histology(IDC), ER ( + ), and Her-2-neu (-) had 1 mm metastasis in a SLN, but had 13 of 16 lymph nodes with metastasis on ALND. The other patient with a primär)- tumor size of 3.9 cm IDC, ER (-), and Her-2-neu (-) had three SLNs each with 1 mm metastasis and 2 of 9 lymph nodes with metastasis on ALND each containing 0.4 cm metastasis. In conclusion, the patients with only 1HC slain evidence of SLN metastasis have a low likelihood of additional metastasis at ALND. However, those patients who did have additional métastases had significant disease burden that would likely manifest as a clinical problem without ALND. Additional studies are required to better define parameters that predict for additional positive nodes at ALND.

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