Histopathologic Characteristics of Sentinel Lymph Node Biopsy in Breast Carcinoma: Uludag University Faculty of Medicine Experience


Elezoglu B., TOLUNAY Ş., Tasdelen I., Gokgoz S.

TURKIYE KLINIKLERI TIP BILIMLERI DERGISI, vol.31, no.6, pp.1324-1329, 2011 (SCI-Expanded) identifier identifier

Abstract

Objective: Nowadays, sentinel lymph node (SLN) biopsy is a standard approach giving information about status of the axillary lymph nodes. Several factors affect metastasis to SLN. In our case, we aimed to indicate histopathological parameters that affect SLN and non-sentinel lymph node (n-SLN) metastasis, the importance of frozen section to determine metastasis and immunohistochemistry method for histopathological examinations. Material and Methods: In Uludag University Faculty of Medicine, 265 cases who had SLN biopsies were retrospectively examined. Frozen sections, permanent sections and sections with immunohistochemistry were found out from the archieve. Then, preparations were re-examined by expert pathologists on breast pathology. Results: The mean age of the cases was 53 years. The most frequently observed tumor type was invasive ductal carcinoma. Most of the cases had nuclear grade 2. One hundred cases are diagnosed as malignant. As a result of implementation of serial sections and immunohistochemistry to 12 cases without metastasis, macro-metastasis in four cases, micro-metastasis in six cases and finally isolated tumour cells in two cases were determined. In primary breast tumor, the presence of venous/vascular invasion (p=0.021), lymphatic invasion (p<0.001), increased primary tumor diameter (p=0.001) and increased age (p=0.026) increased SLN metastasis. In primary breast tumor, the presence of perineural invasion (p=0.033) and lymphatic invasion (p=0.045), increased tumor diameter (p=0.001), and increased number of positive SLNs (p=0.015) caused an increase in n-SLN metastasis. Conclusion: SLN biopsy is a simple and reliable method. In our study, we found statistically significant results between SLN metastasis and age, primary tumor diameter, lymphatic invasion and venous/vascular invasion. Besides, statistically significant relationships were found between n-SLN metastasis and primary tumor diameter, perineural invasion and lymphatic invasion as well. Intraoperative analysis of SLN is very important for staging of breast carcinoma and prognosis. Moreover, accuracy of diagnosis increases with the applications of serial section and immunohistochemical method.