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The Application of 1% Methylene Blue Dye As a Single Technique in Breast Cancer Sentinel Node Biopsy
Published on: June 1, 2019
[Sentinel node biopsy in breast cancer: pathological analysis and interpretation]
Der Pathologe
|February 19, 2009
Summary
Sentinel lymph node biopsy (SLNB) improves breast cancer staging through detailed lymph node analysis. Standardized guidelines are needed to reduce variability in detecting metastases and refine cancer staging categories.
Area of Science:
- Oncology
- Pathology
- Surgical Oncology
Context:
- Sentinel lymph node biopsy (SLNB) has become a standard procedure for staging breast cancer.
- Pathological analysis of sentinel lymph nodes has become more intensive, including gross slicing, step sections, and immunohistological or molecular analysis.
Purpose:
- To examine how the introduction of SLNB has impacted pathological staging in breast cancer.
- To highlight the stage shifting observed due to more intensive analysis of sentinel lymph nodes.
Summary:
- Intensive analysis of sentinel lymph nodes has led to stage shifting in breast cancer.
- Significant inter-institute variability exists in the rate of up-staging by SLNB, related to methodology and interpretation.
- There is a need for reliable guidelines to standardize the identification of metastases (macrometastasis >2 mm minimum).
Impact:
- The TNM classification requires revision for better definitions of staging categories for isolated tumor cells and micrometastases.
- A new staging category is anticipated for molecularly detected metastases larger than isolated tumors.
- Histological investigation of a proportion of lymph nodes is recommended even when nodal staging relies on molecular tests.
