The value of cytokeratin immunohistochemistry in the evaluation of axillary sentinel lymph nodes in patients with lobular breast carcinoma

G. Cserni, S. Bianchi, V. Vezzosi, H. Peterse, A. Sapino, R. Arisio, A. Reiner-Concin, P. Regitnig, J. P. Bellocq, C. Marin, R. Bori, J. M. Penuela, A. Córdoba Iturriagagoitia

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Background: Cytokeratin immunohistochemistry (IHC) reveals a higher rate of occult lymph node metastases among lobular carcinomas than among ductal breast cancers. IHC is widely used but is seldom recommended for the evaluation of sentinel lymph nodes in breast cancer patients. Objective: To assess the value of cytokeratin IHC for the detection of metastases in sentinel lymph nodes of patients with invasive lobular carcinoma. Methods: The value of IHC, the types of metastasis found by this method, and the involvement of non-sentinel lymph nodes were analysed in a multi-institutional cohort of 449 patients with lobular breast carcinoma, staged by sentinel lymph node biopsy and routine assessment of the sentinel lymph nodes by IHC when multilevel haematoxylin and eosin staining revealed no metastasis. Results: 189 patients (42%) had some type of sentinel node involvement, the frequency of this increasing with increasing tumour size. IHC was needed for identification of 65 of these cases: 17 of 19 isolated tumour cells, 40 of 64 micrometastases, and 8 of 106 larger metastases were detected by this means. Non-sentinel-node involvement was noted in 66 of 161 cases undergoing axillary dissection. Although isolated tumour cells were not associated with further lymph node involvement, sentinel node positivity detected by IHC was associated with further nodal metastases in 12 of 50 cases (0.24), a proportion that is higher than previously reported for breast cancer in general. Conclusions: IHC is recommended for the evaluation of sentinel nodes from patients with lobular breast carcinoma, as the micrometastases or larger metastases demonstrated by this method are often associated with a further metastatic nodal load.

Original languageEnglish
Pages (from-to)518-522
Number of pages5
JournalJournal of Clinical Pathology
Volume59
Issue number5
DOIs
Publication statusPublished - May 2006

Fingerprint

Lobular Carcinoma
Keratins
Immunohistochemistry
Breast Neoplasms
Neoplasm Metastasis
Neoplasm Micrometastasis
Lymph Nodes
Carcinoma, Ductal, Breast
Sentinel Lymph Node Biopsy
Neoplasms
Sentinel Lymph Node
Hematoxylin
Eosine Yellowish-(YS)
Dissection
Staining and Labeling

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

The value of cytokeratin immunohistochemistry in the evaluation of axillary sentinel lymph nodes in patients with lobular breast carcinoma. / Cserni, G.; Bianchi, S.; Vezzosi, V.; Peterse, H.; Sapino, A.; Arisio, R.; Reiner-Concin, A.; Regitnig, P.; Bellocq, J. P.; Marin, C.; Bori, R.; Penuela, J. M.; Córdoba Iturriagagoitia, A.

In: Journal of Clinical Pathology, Vol. 59, No. 5, 05.2006, p. 518-522.

Research output: Contribution to journalArticle

Cserni, G, Bianchi, S, Vezzosi, V, Peterse, H, Sapino, A, Arisio, R, Reiner-Concin, A, Regitnig, P, Bellocq, JP, Marin, C, Bori, R, Penuela, JM & Córdoba Iturriagagoitia, A 2006, 'The value of cytokeratin immunohistochemistry in the evaluation of axillary sentinel lymph nodes in patients with lobular breast carcinoma', Journal of Clinical Pathology, vol. 59, no. 5, pp. 518-522. https://doi.org/10.1136/jcp.2005.029991
Cserni, G. ; Bianchi, S. ; Vezzosi, V. ; Peterse, H. ; Sapino, A. ; Arisio, R. ; Reiner-Concin, A. ; Regitnig, P. ; Bellocq, J. P. ; Marin, C. ; Bori, R. ; Penuela, J. M. ; Córdoba Iturriagagoitia, A. / The value of cytokeratin immunohistochemistry in the evaluation of axillary sentinel lymph nodes in patients with lobular breast carcinoma. In: Journal of Clinical Pathology. 2006 ; Vol. 59, No. 5. pp. 518-522.
@article{59365d5a83c549b792b34e7ac999c567,
title = "The value of cytokeratin immunohistochemistry in the evaluation of axillary sentinel lymph nodes in patients with lobular breast carcinoma",
abstract = "Background: Cytokeratin immunohistochemistry (IHC) reveals a higher rate of occult lymph node metastases among lobular carcinomas than among ductal breast cancers. IHC is widely used but is seldom recommended for the evaluation of sentinel lymph nodes in breast cancer patients. Objective: To assess the value of cytokeratin IHC for the detection of metastases in sentinel lymph nodes of patients with invasive lobular carcinoma. Methods: The value of IHC, the types of metastasis found by this method, and the involvement of non-sentinel lymph nodes were analysed in a multi-institutional cohort of 449 patients with lobular breast carcinoma, staged by sentinel lymph node biopsy and routine assessment of the sentinel lymph nodes by IHC when multilevel haematoxylin and eosin staining revealed no metastasis. Results: 189 patients (42{\%}) had some type of sentinel node involvement, the frequency of this increasing with increasing tumour size. IHC was needed for identification of 65 of these cases: 17 of 19 isolated tumour cells, 40 of 64 micrometastases, and 8 of 106 larger metastases were detected by this means. Non-sentinel-node involvement was noted in 66 of 161 cases undergoing axillary dissection. Although isolated tumour cells were not associated with further lymph node involvement, sentinel node positivity detected by IHC was associated with further nodal metastases in 12 of 50 cases (0.24), a proportion that is higher than previously reported for breast cancer in general. Conclusions: IHC is recommended for the evaluation of sentinel nodes from patients with lobular breast carcinoma, as the micrometastases or larger metastases demonstrated by this method are often associated with a further metastatic nodal load.",
author = "G. Cserni and S. Bianchi and V. Vezzosi and H. Peterse and A. Sapino and R. Arisio and A. Reiner-Concin and P. Regitnig and Bellocq, {J. P.} and C. Marin and R. Bori and Penuela, {J. M.} and {C{\'o}rdoba Iturriagagoitia}, A.",
year = "2006",
month = "5",
doi = "10.1136/jcp.2005.029991",
language = "English",
volume = "59",
pages = "518--522",
journal = "Journal of Clinical Pathology - Clinical Molecular Pathology",
issn = "0021-9746",
publisher = "BMJ Publishing Group",
number = "5",

}

TY - JOUR

T1 - The value of cytokeratin immunohistochemistry in the evaluation of axillary sentinel lymph nodes in patients with lobular breast carcinoma

AU - Cserni, G.

AU - Bianchi, S.

AU - Vezzosi, V.

AU - Peterse, H.

AU - Sapino, A.

AU - Arisio, R.

AU - Reiner-Concin, A.

AU - Regitnig, P.

AU - Bellocq, J. P.

AU - Marin, C.

AU - Bori, R.

AU - Penuela, J. M.

AU - Córdoba Iturriagagoitia, A.

PY - 2006/5

Y1 - 2006/5

N2 - Background: Cytokeratin immunohistochemistry (IHC) reveals a higher rate of occult lymph node metastases among lobular carcinomas than among ductal breast cancers. IHC is widely used but is seldom recommended for the evaluation of sentinel lymph nodes in breast cancer patients. Objective: To assess the value of cytokeratin IHC for the detection of metastases in sentinel lymph nodes of patients with invasive lobular carcinoma. Methods: The value of IHC, the types of metastasis found by this method, and the involvement of non-sentinel lymph nodes were analysed in a multi-institutional cohort of 449 patients with lobular breast carcinoma, staged by sentinel lymph node biopsy and routine assessment of the sentinel lymph nodes by IHC when multilevel haematoxylin and eosin staining revealed no metastasis. Results: 189 patients (42%) had some type of sentinel node involvement, the frequency of this increasing with increasing tumour size. IHC was needed for identification of 65 of these cases: 17 of 19 isolated tumour cells, 40 of 64 micrometastases, and 8 of 106 larger metastases were detected by this means. Non-sentinel-node involvement was noted in 66 of 161 cases undergoing axillary dissection. Although isolated tumour cells were not associated with further lymph node involvement, sentinel node positivity detected by IHC was associated with further nodal metastases in 12 of 50 cases (0.24), a proportion that is higher than previously reported for breast cancer in general. Conclusions: IHC is recommended for the evaluation of sentinel nodes from patients with lobular breast carcinoma, as the micrometastases or larger metastases demonstrated by this method are often associated with a further metastatic nodal load.

AB - Background: Cytokeratin immunohistochemistry (IHC) reveals a higher rate of occult lymph node metastases among lobular carcinomas than among ductal breast cancers. IHC is widely used but is seldom recommended for the evaluation of sentinel lymph nodes in breast cancer patients. Objective: To assess the value of cytokeratin IHC for the detection of metastases in sentinel lymph nodes of patients with invasive lobular carcinoma. Methods: The value of IHC, the types of metastasis found by this method, and the involvement of non-sentinel lymph nodes were analysed in a multi-institutional cohort of 449 patients with lobular breast carcinoma, staged by sentinel lymph node biopsy and routine assessment of the sentinel lymph nodes by IHC when multilevel haematoxylin and eosin staining revealed no metastasis. Results: 189 patients (42%) had some type of sentinel node involvement, the frequency of this increasing with increasing tumour size. IHC was needed for identification of 65 of these cases: 17 of 19 isolated tumour cells, 40 of 64 micrometastases, and 8 of 106 larger metastases were detected by this means. Non-sentinel-node involvement was noted in 66 of 161 cases undergoing axillary dissection. Although isolated tumour cells were not associated with further lymph node involvement, sentinel node positivity detected by IHC was associated with further nodal metastases in 12 of 50 cases (0.24), a proportion that is higher than previously reported for breast cancer in general. Conclusions: IHC is recommended for the evaluation of sentinel nodes from patients with lobular breast carcinoma, as the micrometastases or larger metastases demonstrated by this method are often associated with a further metastatic nodal load.

UR - http://www.scopus.com/inward/record.url?scp=33646414175&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33646414175&partnerID=8YFLogxK

U2 - 10.1136/jcp.2005.029991

DO - 10.1136/jcp.2005.029991

M3 - Article

C2 - 16497870

AN - SCOPUS:33646414175

VL - 59

SP - 518

EP - 522

JO - Journal of Clinical Pathology - Clinical Molecular Pathology

JF - Journal of Clinical Pathology - Clinical Molecular Pathology

SN - 0021-9746

IS - 5

ER -