Pathologic analysis of sentinel lymph nodes

Area of Science:

• Oncology
• Pathology
• Surgical Oncology

Background:

• The sentinel lymph node (SLN) procedure targets the first lymph node to form metastases.
• A negative SLN accurately predicts the absence of metastases in other regional lymph nodes.
• This procedure can prevent unnecessary morbidity and reduce healthcare costs associated with lymph node dissection.

Purpose of the Study:

• To discuss the value of various pathological techniques for detecting SLN metastases.
• To evaluate methods for intraoperative assessment of SLNs.
• To highlight the importance of accurate SLN metastasis detection for treatment decisions.

Main Methods:

• Review of standard histopathological techniques (hematoxylin and eosin, immunohistochemistry).
• Evaluation of cytopathological techniques like imprint cytology.
• Discussion of advanced methods including flow cytometry and molecular techniques (RT-PCR).

Main Results:

• Standard histopathological investigation with HE staining and immunohistochemistry is the established protocol.
• Intraoperative frozen section analysis and imprint cytology show reasonable reliability for breast cancer SLN metastasis detection.
• Further research is needed to define the role of multiparameter flow cytometry and molecular techniques.

Conclusions:

• Accurate pathological screening of SLNs is essential for the success of the SLN procedure.
• Current methods like histopathology and cytology are valuable, with some utility for intraoperative evaluation.
• Advanced techniques require further validation to establish their role in SLN metastasis detection.